Cersosimo Angelica, Bonelli Andrea, Lombardi Carlo M, Moreo Antonella, Pagnesi Matteo, Tomasoni Daniela, Arabia Gianmarco, Vizzardi Enrico, Adamo Marianna, Farina Davide, Metra Marco, Inciardi Riccardo M
ASST Spedali Civili di Brescia, Division of Cardiology and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
ASST Grande Ospedale Metropolitano Niguarda, "A. De Gasperis" Department, Cardiology IV, Milan, Italy.
Front Cardiovasc Med. 2023 Mar 14;10:1108696. doi: 10.3389/fcvm.2023.1108696. eCollection 2023.
Severe aortic stenosis (AS) is the most common valvular heart disease with a prevalence rate of more than 4% in 75-year-old people or older. Similarly, cardiac amyloidosis (CA), especially "wild-type transthyretin" (wTTR), has shown a prevalence rate ranging from 22% to 25% in people older than 80 years. The detection of the concomitant presence of CA and AS is challenging primarily because of the similar type of changes in the left ventricle caused by AS and CA, which share some morphological characteristics. The aim of this review is to identify the imaging triggers in order to recognize occult wtATTR-CA in patients with AS, clarifying the crucial step of the diagnostic process. Multimodality imaging methods such as echocardiography, cardiac magnetic resonance, cardiac computed tomography, and DPD scintigraphy will be analyzed as part of the available diagnostic workup to identify wtATTR-CA early in patients with AS.
重度主动脉瓣狭窄（AS）是最常见的心脏瓣膜病，在75岁及以上人群中的患病率超过4%。同样，心脏淀粉样变性（CA），尤其是“野生型转甲状腺素蛋白”（wTTR），在80岁以上人群中的患病率为22%至25%。CA和AS并存的检测具有挑战性，主要是因为AS和CA引起的左心室变化类型相似，它们具有一些共同的形态学特征。本综述的目的是确定成像触发因素，以便在AS患者中识别隐匿性wtATTR-CA，阐明诊断过程的关键步骤。超声心动图、心脏磁共振、心脏计算机断层扫描和DPD闪烁扫描等多模态成像方法将作为现有诊断检查的一部分进行分析，以便在AS患者中早期识别wtATTR-CA。
