White James A, Fine Nowell M
Stephenson Cardiovascular Imaging Center, University of Calgary, Calgary, Alberta, Canada.
Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Curr Cardiol Rep. 2016 Aug;18(8):77. doi: 10.1007/s11886-016-0752-7.
Cardiac amyloidosis is a form of infiltrative cardiomyopathy typically presenting with progressive heart failure. The clinical presentation and morphological findings often overlap with other cardiovascular diseases, and frequently results in misdiagnosis and consequent under-reporting. Cardiovascular imaging is playing an increasingly important diagnostic and prognostic role in this referral population, and is reducing the reliance on endomyocardial biopsy as a confirmatory testing. Advancements across multiple cardiac imaging modalities, including echocardiography, magnetic resonance imaging, nuclear imaging, and computed tomography, are improving diagnostic accuracy and offering novel approaches to sub-type differentiation and prognostication. This review explores recent advancements in cardiac imaging for the diagnosis, typing, and staging of cardiac amyloidosis, with a focus on new and evolving techniques. Emphasis is also placed on the promise of non-invasive cardiac imaging to provide value across the spectrum of this clinical disease, from early disease identification (prior to the development of increased wall thickness) through to markers of advanced disease associated with early mortality.
心脏淀粉样变性是浸润性心肌病的一种形式，通常表现为进行性心力衰竭。其临床表现和形态学特征常与其他心血管疾病重叠，常导致误诊及报告不足。心血管成像在这类转诊人群中发挥着越来越重要的诊断和预后作用，减少了对心内膜心肌活检作为确诊检查的依赖。包括超声心动图、磁共振成像、核成像和计算机断层扫描在内的多种心脏成像模式的进展，正在提高诊断准确性，并为亚型区分和预后评估提供新方法。本综述探讨了心脏成像在心脏淀粉样变性诊断、分型和分期方面的最新进展，重点关注新出现和不断发展的技术。还强调了无创心脏成像在这一临床疾病全病程中提供价值的前景，从疾病早期识别（在心室壁厚度增加之前）到与早期死亡相关的晚期疾病标志物。
