Integrated multimodality imaging, including echocardiography, CMR, and nuclear imaging, is essential for the timely diagnosis of transthyretin cardiac amyloidosis in patients with aortic stenosis.
This review highlights the importance of multimodality imaging in diagnosing coexisting ATTR-CA in patients with degenerative aortic stenosis to guide appropriate therapies.
Transthyretin cardiac amyloidosis (ATTR-CA) is a challenging and underdiagnosed cause of heart failure. Advances in cardiac imaging have enabled noninvasive diagnosis of ATTR-CA, causing the recent upsurge in disease awareness and detection. ATTR-CA has been increasingly recognized in patients with degenerative aortic stenosis (AS). With the growing number of elderly patients undergoing aortic valve intervention, the identification of ATTR-CA in this group of patients is of high clinical importance. Timely and correct diagnosis is essential for amyloid-directed therapies, as well as deciding on the AS treatment strategy. This review provides a comprehensive overview of the recent studies investigating coexistence of these two entities. We present the data on the prevalence of ATTR-CA in AS and their prognostic associations. As the diagnosis of ATTR-CA may be challenging, special attention is paid to the diagnostic utility of different imaging modalities, namely, echocardiography, cardiovascular magnetic resonance, nuclear imaging, and distinctive imaging features, in patients with dual pathology. We also present a flowchart summarizing integrated imaging in patients with suspected ATTR-CA.
Balčiūnaitė et al. (Fri,) conducted a review in Transthyretin cardiac amyloidosis and aortic stenosis. Multimodality imaging was evaluated. Integrated multimodality imaging, including echocardiography, CMR, and nuclear imaging, is essential for the timely diagnosis of transthyretin cardiac amyloidosis in patients with aortic stenosis.
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