Alqarni Abdullah, Aljizeeri Ahmed, Bakhsh Aquib Mohammadidrees, El-Zeftawy Hossam Ahmed Maher, Farghaly Hussein R, Alqadhi Mukhtar Ahmed M, Algarni Mushref, Asiri Zain Mohammed, Osman Ahmed, Haddadin Haya, Alayary Islam, Al-Mallah Mouaz H
Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia.
King Abdulaziz Cardiac Center, Ministry of the National Guard Health Affairs, Riyadh 14626, Saudi Arabia.
Diagnostics (Basel). 2024 Jan 18;14(2):212. doi: 10.3390/diagnostics14020212.
Transthyretin amyloid cardiomyopathy (ATTR-CM) is a complex and serious form of heart failure caused by the accumulation of transthyretin amyloid protein in the heart muscle. Variable symptoms of ATTR-CM can lead to a delayed diagnosis. Recognizing the diagnostic indicators is crucial to promptly detect this condition. A targeted literature review was conducted to examine the latest international consensus recommendations on a comprehensive diagnosis of ATTR-CM. Additionally, a panel consisting of nuclear medicine expert consultants ( = 10) and nuclear imaging technicians ( = 2) convened virtually from the Kingdom of Saudi Arabia (KSA) to formulate best practices for ATTR-CM diagnosis. The panel reached a consensus on a standard diagnostic pathway for ATTR-CM, which commences by evaluating the presence of clinical red flags and initiating a cardiac workup to assess the patient's echocardiogram. Cardiac magnetic resonance imaging may be needed, in uncertain cases. When there is a high suspicion of ATTR-CM, patients undergo nuclear scintigraphy and hematologic tests to rule out primary or light-chain amyloidosis. The expert panel emphasized that implementing best practices will support healthcare professionals in KSA to improve their ability to detect and diagnose ATTR-CM more accurately and promptly. Diagnosing ATTR-CM accurately and early can reduce morbidity and mortality rates through appropriate treatment.
转甲状腺素蛋白淀粉样变心肌病(ATTR-CM)是一种复杂且严重的心力衰竭形式,由转甲状腺素蛋白淀粉样蛋白在心肌中积聚所致。ATTR-CM的症状多样,可能导致诊断延迟。识别诊断指标对于及时发现这种疾病至关重要。我们进行了一项有针对性的文献综述,以研究关于ATTR-CM综合诊断的最新国际共识建议。此外,一个由核医学专家顾问( = 10)和核成像技术人员( = 2)组成的小组从沙特阿拉伯王国(KSA)进行了线上会议,以制定ATTR-CM诊断的最佳实践。该小组就ATTR-CM的标准诊断途径达成了共识,该途径首先评估临床警示信号的存在,并启动心脏检查以评估患者的超声心动图。在不确定的情况下,可能需要进行心脏磁共振成像。当高度怀疑ATTR-CM时,患者要接受核闪烁扫描和血液学检查,以排除原发性或轻链淀粉样变。专家小组强调,实施最佳实践将支持沙特阿拉伯王国的医疗保健专业人员提高其更准确、及时地检测和诊断ATTR-CM的能力。通过适当治疗,准确早期诊断ATTR-CM可以降低发病率和死亡率。