Key result
Natriuretic peptides and troponins complement imaging to stage and track progression in cardiac amyloidosis.
Why the study?
Imaging techniques for cardiac amyloidosis have several limitations that may be overcome by cardiac biomarkers to detect early disease, assess stage, and monitor treatment response.
Cardiac biomarkers (natriuretic peptides and troponins) are essential complementary tools to imaging for staging and monitoring treatment response in cardiac amyloidosis.
Answers are grounded in this paper and cite their sources.
Supports complementary biomarker use with imaging for cardiac amyloidosis staging; leaves open prospective validation trials.
Amyloidosis refers to a heterogenous group of systemic diseases characterized by the presence of a misfolded protein that deposits as amyloid fibrils in the interstitium of organs and tissues. The vast majority of cases of cardiac involvement (cardiac amyloidosis - CA) are due to immunoglobulin light chain (AL) amyloidosis, or transthyretin (ATTR) amyloidosis (either in its wild-type form - ATTRwt, or variant - ATTRv). The diagnostic workup of these diseases reflects the differences in terms of aetiology. Although imaging techniques represent fundamental tools in the diagnosis and follow-up of patients CA, they present several limitations. Cardiac biomarkers, particularly natriuretic peptides and troponins, overcome most of these limitations. They can be more sensitive in the detection of early phases of the disease but, overall, they currently represent the most powerful tool to define disease stage, organ response and disease progression. There is mounting evidence regarding the use of specific laboratory biomarkers to monitor treatment response. The information provided by advanced imaging techniques should be regarded as complementary and not as substitute for that provided by laboratory biomarkers, as only these can often be able to unveil the unseen.
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Sanna et al. (2026) conducted a review in Cardiac amyloidosis. Cardiac biomarkers (natriuretic peptides and troponins) vs. Imaging techniques was evaluated. Cardiac biomarkers, particularly natriuretic peptides and troponins, provide complementary information to imaging for defining disease stage, organ response, and progression in cardiac amyloidosis.
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