Usuku Hiroki, Oike Fumi, Kuyama Naoto, Hirakawa Kyoko, Takashio Seiji, Izumiya Yasuhiro, Tsujita Kenichi
Department of Laboratory Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
J Echocardiogr. 2025 Mar;23(1):1-9. doi: 10.1007/s12574-024-00672-w. Epub 2024 Dec 27.
Transthyretin amyloid cardiomyopathy (ATTR-CM) is becoming increasingly recognized with the aging population, advancements in understanding of disease pathobiology and the potential benefits of emerging therapies. Bone scintigraphy, including Tc-labeled pyrophosphate scintigraphy, is currently considered the first-line modality for identifying ATTR-CM. Therefore, it is important to increase the preset probability using inexpensive and simple tests including echocardiography. Although there were a lot of typical echocardiographic findings of amyloid cardiomyopathy, unexplained left ventricular (LV) wall thickness, LV apical sparing, and a discrepancy between LV wall thickness and QRS voltage were selected as red flags/clues for ATTR-CM in various current diagnostic algorithms. Although echocardiography is useful for ATTR-CM screening, there are several limitations. Therefore, it is important to perform echocardiography and combine it with physical examination, laboratory findings, and other imaging data.
随着人口老龄化、对疾病病理生物学认识的进步以及新兴疗法的潜在益处，转甲状腺素蛋白淀粉样变心肌病（ATTR-CM）越来越受到关注。骨闪烁显像，包括锝标记焦磷酸盐闪烁显像，目前被认为是识别ATTR-CM的一线检查方法。因此，使用包括超声心动图在内的廉价且简单的检查来提高预设概率很重要。虽然淀粉样变心肌病有许多典型的超声心动图表现，但在目前各种诊断算法中，无法解释的左心室（LV）壁厚度、LV心尖 sparing以及LV壁厚度与QRS电压之间的差异被选为ATTR-CM的警示信号/线索。虽然超声心动图对ATTR-CM筛查有用，但也有一些局限性。因此，进行超声心动图检查并将其与体格检查、实验室检查结果及其他影像学数据相结合很重要。
