PMID- 31796976 OWN - NLM STAT- MEDLINE DCOM- 20210415 LR - 20220422 IS - 1615-6692 (Electronic) IS - 0340-9937 (Linking) VI - 46 IP - Suppl 1 DP - 2021 Apr TI - Cardiac amyloidosis: in search of the ideal diagnostic tool. PG - 9-14 LID - 10.1007/s00059-019-04871-5 [doi] AB - BACKGROUND: Cardiac amyloidosis (CA) is due to amyloid deposition in the myocardium. Transthyretin (ATTR) and light-chain (AL) amyloidosis are the main types of CA. Here, we present the clinical and imaging findings in patients with CA and discuss the controversies with the aim of finding the ideal diagnostic tool. METHODS: Ten patients suspected of having CA on the basis of electrocardiographic (ECG) and echocardiographic findings were evaluated via cardiovascular magnetic resonance imaging (CMR; 1.5 T) using cine, late gadolinium enhancement (LGE), T1, T2 mapping, and extracellular volume fraction. N‑terminal pro-B-type natriuretic peptide (NT-proBNP) levels were also assessed in all patients. RESULTS: All ten patients had an echocardiogram suggestive of CA. The CMR study documented ventricular hypertrophy leading to small ventricular volumes, as assessed by echocardiography. Diffuse subendocardial LGE, supporting the diagnosis of CA, was identified in all except one patient, who had subepicardial LGE due to myocarditis that was verified by endomyocardial biopsy (EMB). Right ventricular (RV) involvement was identified in four of the ten patients, whose condition deteriorated rapidly over the next 6 months. The NT-proBNP levels were >332 pg/ml in all except two patients. Light-chain amyloidosis was identified via fat tissue biopsy in two patients and through renal biopsy in one patient. In two patients with positive technetium-99m, EMB confirmed the diagnosis of ATTR. CONCLUSION: NT-proBNP may be a sensitive but nonspecific biomarker for assessing CA. However, CMR is the only imaging modality that can assess the pathophysiologic background of cardiac hypertrophy and the severity of CA, irrespective of NT-proBNP level. FAU - Mavrogeni, Sophie I AU - Mavrogeni SI AD - Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, P. Faliro, Athens, Greece. soma13@otenet.gr. FAU - Vartela, Vasiliki AU - Vartela V AD - Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, P. Faliro, Athens, Greece. FAU - Ntalianis, Argyrios AU - Ntalianis A AD - Alexandra's Hospital, Athens, Greece. FAU - Vretou, Rosa AU - Vretou R AD - Attikon Hospital, Athens, Greece. FAU - Ikonomidis, Ignatios AU - Ikonomidis I AD - Attikon Hospital, Athens, Greece. FAU - Tselegkidou, Marini AU - Tselegkidou M AD - Alexandra's Hospital, Athens, Greece. FAU - Paraskevaidis, Ioannis AU - Paraskevaidis I AD - Alexandra's Hospital, Athens, Greece. FAU - Markousis-Mavrogenis, George AU - Markousis-Mavrogenis G AD - Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, P. Faliro, Athens, Greece. FAU - Noutsias, Michel AU - Noutsias M AD - Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany. FAU - Rigopoulos, Angelos AU - Rigopoulos A AD - Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany. FAU - Kolovou, Genovefa AU - Kolovou G AD - Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, P. Faliro, Athens, Greece. FAU - Kastritis, Efstathios AU - Kastritis E AD - Alexandra's Hospital, Athens, Greece. LA - eng PT - Journal Article PT - Review TT - Kardiale Amyloidose: Suche nach dem idealen diagnostischen Verfahren. DEP - 20191203 PL - Germany TA - Herz JT - Herz JID - 7801231 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - *Amyloidosis/diagnostic imaging MH - *Cardiomyopathies/diagnostic imaging MH - Contrast Media MH - Gadolinium MH - Humans MH - Magnetic Resonance Imaging MH - Myocardium MH - Predictive Value of Tests MH - Prognosis OTO - NOTNLM OT - Cardiac amyloidosis OT - Cardiovascular magnetic resonance imaging OT - Echocardiography OT - Electrocardiography OT - N‑terminal pro-BNP EDAT- 2019/12/05 06:00 MHDA- 2021/04/16 06:00 CRDT- 2019/12/05 06:00 PHST- 2018/10/26 00:00 [received] PHST- 2019/11/12 00:00 [accepted] PHST- 2018/10/26 00:00 [revised] PHST- 2019/12/05 06:00 [pubmed] PHST- 2021/04/16 06:00 [medline] PHST- 2019/12/05 06:00 [entrez] AID - 10.1007/s00059-019-04871-5 [pii] AID - 10.1007/s00059-019-04871-5 [doi] PST - ppublish SO - Herz. 2021 Apr;46(Suppl 1):9-14. doi: 10.1007/s00059-019-04871-5. Epub 2019 Dec 3.