Key result
Multimodality cardiovascular imaging guides diagnosis and management in pediatric cardiomyopathies, led by first-line echocardiography.
Why the study?
Diagnosing and classifying cardiomyopathy phenotypes in pediatric patients is challenging, requiring cardiovascular imaging across screening, classification, and follow-up.
What are the strengths, limitations, and roles of different multimodality imaging techniques in evaluating pediatric patients with cardiomyopathies?
What are the strengths, limitations, and roles of different multimodality imaging techniques in evaluating pediatric patients with cardiomyopathies?
This review provides a comprehensive overview of how to integrate echocardiography, CMR, CT, and nuclear imaging for the optimal evaluation and risk stratification of pediatric cardiomyopathies.
May guide imaging choices in pediatric cardiomyopathies; leaves open need for prospective validation studies.
Cardiomyopathies are a heterogeneous group of myocardial diseases representing the first cause of heart transplantation in children. Diagnosing and classifying the different phenotypes can be challenging, particularly in this age group, where cardiomyopathies are often overlooked until the onset of severe symptoms. Cardiovascular imaging is crucial in the diagnostic pathway, from screening to classification and follow-up assessment. Several imaging modalities have been proven to be helpful in this field, with echocardiography undoubtedly representing the first imaging approach due to its low cost, lack of radiation, and wide availability. However, particularly in this clinical context, echocardiography may not be able to differentiate from cardiomyopathies with similar phenotypes and is often complemented with cardiovascular magnetic resonance. The latter allows a radiation-free differentiation between different phenotypes with unique myocardial tissue characterization, thus identifying the presence and extent of myocardial fibrosis. Nuclear imaging and computed tomography have a complementary role, although they are less used in daily clinical practice due to the concern related to the use of radiation in pediatric patients. However, these modalities may have some advantages in evaluating children with cardiomyopathies. This paper aims to review the strengths and limitations of each imaging modality in evaluating pediatric patients with suspected or known cardiomyopathies.
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Moscatelli et al. (2023) conducted a review in Pediatric cardiomyopathies. Multimodality cardiovascular imaging (Echocardiography, CMR, CCT, Nuclear imaging) was evaluated. Multimodality cardiovascular imaging is essential for diagnosing and managing pediatric cardiomyopathies, with echocardiography as the first-line approach complemented by CMR, CCT, and nuclear imaging.
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