National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
Curr Cardiol Rep. 2022 Jul;24(7):839-850. doi: 10.1007/s11886-022-01703-7. Epub 2022 May 7.
This review will explore the role of cardiac imaging in guiding treatment in the two most commonly encountered subtypes of cardiac amyloidosis (immunoglobulin light-chain amyloidosis [AL] and transthyretin amyloidosis [ATTR]).
Advances in multi-parametric cardiac imaging involving a combination of bone scintigraphy, echocardiography and cardiac magnetic resonance imaging have resulted in earlier diagnosis and initiation of treatment, while the evolution of techniques such as longitudinal strain and extracellular volume quantification allow clinicians to track individuals' response to treatment. Imaging developments have led to a deeper understanding of the disease process and treatment mechanisms, which in combination result in improved patient outcomes. The rapidly expanding treatment regimens for cardiac amyloidosis have led to an even greater reliance on cardiac imaging to help establish an accurate diagnosis, monitor treatment response and aid the adjustment of treatment strategies accordingly.
本篇综述将探讨心脏影像学在指导两种最常见的心脏淀粉样变(免疫球蛋白轻链淀粉样变 [AL] 和转甲状腺素蛋白淀粉样变 [ATTR])亚型治疗中的作用。
多参数心脏成像技术的进步,包括骨闪烁显像、超声心动图和心脏磁共振成像的结合,使早期诊断和治疗成为可能,而纵向应变和细胞外容积定量等技术的发展使临床医生能够跟踪个体对治疗的反应。影像学的发展使我们对疾病过程和治疗机制有了更深入的了解,从而改善了患者的预后。心脏淀粉样变的治疗方案迅速扩大,这使得我们更加依赖心脏影像学来帮助确定准确的诊断、监测治疗反应并相应地调整治疗策略。