Houston Methodist Debakey Heart & Vascular Center, Houston, Texas, USA.
Curr Opin Cardiol. 2024 Sep 1;39(5):389-394. doi: 10.1097/HCO.0000000000001167. Epub 2024 Jul 5.
Cardiac amyloidosis is a condition marked by the misfolding of precursor proteins into insoluble amyloid fibrils, leading to restrictive cardiomyopathy and heart failure symptoms. This review discusses advancements in nuclear imaging techniques that enhance the diagnosis and guide the management of cardiac amyloidosis, addressing the critical need for early and accurate detection in clinical practice.
Recent studies and guidelines emphasizes the pivotal role of nuclear imaging techniques in diagnosing cardiac amyloidosis. Cardiac scintigraphy, using bone-avid tracers like 99mTc-PYP, 99mTc-DPD, and 99mTc-HMDP, is instrumental in distinguishing between transthyretin amyloidosis and light chain amyloidosis. PET, with tracers such as 11C-Pittsburgh Compound B (11C-PiB) and 18F-Florbetapir, offers significant potential in measuring amyloid burden and monitoring disease progression, providing detailed insights into the myocardial involvement.
The advancements in nuclear imaging techniques significantly impact the management of cardiac amyloidosis. These methods allow for a more accurate diagnosis, detailed assessment of disease extent, and better differentiation between amyloidosis types, which are crucial for tailoring treatment approaches. The integration of these techniques into clinical practice is essential for improving patient outcomes and advancing research in cardiac amyloidosis.
心脏淀粉样变性是一种由前体蛋白错误折叠成不溶性淀粉样纤维而导致的疾病,其特征为限制性心肌病和心力衰竭症状。本综述讨论了核成像技术的进展,这些技术增强了心脏淀粉样变性的诊断和指导管理,满足了临床实践中对早期和准确检测的迫切需求。
最近的研究和指南强调了核成像技术在诊断心脏淀粉样变性中的关键作用。心脏闪烁显像术使用骨靶向示踪剂,如 99mTc-PYP、99mTc-DPD 和 99mTc-HMDP,有助于区分转甲状腺素淀粉样变性和轻链淀粉样变性。正电子发射断层扫描术(PET)使用示踪剂,如 11C-匹兹堡化合物 B(11C-PiB)和 18F-氟比他比,具有测量淀粉样物质负荷和监测疾病进展的巨大潜力,为心肌受累提供了详细的见解。
核成像技术的进步对心脏淀粉样变性的管理具有重大影响。这些方法可以更准确地诊断、详细评估疾病的范围,并更好地区分淀粉样变性的类型,这对于制定治疗方法至关重要。将这些技术整合到临床实践中对于改善患者的预后和推进心脏淀粉样变性的研究至关重要。