Romero Pabón Ardel J, Clerc Olivier F, Vijayakumar Shilpa, Cuddy Sarah A M, Dorbala Sharmila
Division of Cardiology, Department of Medicine, Cardiac Amyloidosis Program, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Curr Cardiol Rep. 2024 Nov;26(11):1153-1162. doi: 10.1007/s11886-024-02114-6. Epub 2024 Aug 13.
Cardiac amyloidosis includes a group of protein-misfolding diseases characterized by fibril accumulation within the extracellular space of the myocardium and cardiac dysfunction. Cardiac amyloidosis has high mortality. Emerging radionuclide techniques have helped us to better understand disease pathogenesis, prognostication, and treatment response in cardiac amyloidosis. PURPOSE OF REVIEW: To review recent advances in molecular imaging of cardiac amyloidosis using amyloid PET radiotracers. RECENT FINDINGS: Multiple single center studies have shown that amyloid PET radiotracers allow definitive diagnosis and quantification of cardiac amyloid burden. These amyloid targeting tracers may provide means to improve early disease detection, risk stratification and treatment monitoring. Amyloid PET imaging may inform definitive imaging-based diagnosis for therapeutic decisions, risk stratification, and treatment monitoring. More research in unselected cohorts of patients with suspected cardiac amyloidosis is needed to optimize the clinical implementation of amyloid PET imaging.
心脏淀粉样变性是一组蛋白质错误折叠疾病，其特征是心肌细胞外空间内有原纤维积聚以及心脏功能障碍。心脏淀粉样变性死亡率很高。新兴的放射性核素技术有助于我们更好地理解心脏淀粉样变性的疾病发病机制、预后及治疗反应。综述目的：使用淀粉样蛋白PET放射性示踪剂综述心脏淀粉样变性分子成像的最新进展。最新发现：多项单中心研究表明，淀粉样蛋白PET放射性示踪剂可对心脏淀粉样蛋白负荷进行明确诊断和定量。这些靶向淀粉样蛋白的示踪剂可能为改善疾病早期检测、风险分层及治疗监测提供手段。淀粉样蛋白PET成像可为基于成像的明确诊断提供依据，以用于治疗决策、风险分层及治疗监测。需要对更多未选定的疑似心脏淀粉样变性患者队列进行研究，以优化淀粉样蛋白PET成像的临床应用。
