Key result
Noninvasive evaluation increasingly guides targeted therapies for restrictive and infiltrative cardiomyopathies in elderly HFpEF.
Narrative review outlines the diagnostic spectrum of restrictive and infiltrative cardiomyopathies in affected individuals, highlighting advances in noninvasive imaging and targeted therapies.
Restrictive cardiomyopathies are the least common form of heart muscle disease. They are characterized as infiltrative and noninfiltrative, storage diseases, and endomyocardial disorders. Genetic diseases commonly present during childhood or adolescence. However, a growing percentage of elderly patients with heart failure with preserved ejection fraction are being recognized as having forms of restrictive cardiomyopathy, particularly cardiac amyloidosis. Noninvasive evaluation has replaced endomyocardial biopsy in the diagnostic evaluation of most suspected etiologies. The detection of infiltrative cardiomyopathies, including lysosomal and glycogen storage disorders, iron overload, and amyloidosis (both light chain amyloidosis and transthyretin amyloidosis variants), as well as inflammatory diseases such as sarcoidosis has slowly led to improved outcomes via disease-specific therapies.
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Pereira et al. (2018) conducted a review in Restrictive and Infiltrative Cardiomyopathies. Restrictive and infiltrative cardiomyopathies are increasingly recognized, particularly in elderly patients with heart failure with preserved ejection fraction, with noninvasive evaluation guiding disease-specific therapies.
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