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Review article

https://doi.org/10.21860/medflum2022_280996

Nuclear medicine diagnostics of cardiac amyloidosis

Dorian Tokmadžić ; Landeskrankenhaus Villach, Villach, Austria
Neva Girotto orcid id orcid.org/0000-0001-5445-3310 ; Sveučilište u Rijeci, Medicinski fakultet, Katedra za nuklearnu medicinu, Rijeka, Hrvatska
Teodora Zaninović Jurjević ; Sveučilište u Rijeci, Medicinski fakultet, Katedra za internu medicinu, Rijeka, Hrvatska
Sanja Klobučar orcid id orcid.org/0000-0002-0287-4735 ; Sveučilište u Rijeci, Medicinski fakultet, Katedra za internu medicinu, Rijeka, Hrvatska
Svjetlana Grbac Ivanković ; Sveučilište u Rijeci, Medicinski fakultet, Katedra za nuklearnu medicinu, Rijeka, Hrvatska
Tatjana Bogović Crnčić orcid id orcid.org/0000-0003-4152-7928 ; Sveučilište u Rijeci, Medicinski fakultet, Katedra za nuklearnu medicinu, Rijeka, Hrvatska


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Abstract

Cardiac amyloidosis develops due to the accumulation of misfolded or polymerized proteins, most commonly transthyretin or light chains of immunoglobulins in the myocardial extracellular tissue. The disease is still hard to detect because it is rarely suspected as a possible cause of heart failure. The diagnosis is made on the basis of clinical symptoms, patient history, cardiac biomarkers, changes in the electrocardiogram, echocardiographic findings and/or magnetic resonance imaging, which together may indicate the diagnosis. Until recently endomyocardial biopsy was the only reliable diagnostic method to correctly diagnose this disease, but it is an invasive procedure. Nuclear medicine offers the possibility of non-invasive diagnosis, but only in patients fulfilling typical clinical criteria. Gamma- and positron emitting radiopharmaceuticals used for skeletal imaging and direct visualization of amyloid plaques accumulate in the myocardium affected by amyloidosis. The diagnostic value of scintigraphy depends on the use of this method in the correct clinical setting and according to the diagnostic algorithm. In recent years, transthyretin amyloidosis has become increasingly recognized as the cause of heart failure and new therapeutic options are being developed. Therefore, the interest in diagnostics, especially scintigraphy, has increased and numerous research studies are being conducted, especially in the field of PET/CT diagnostics.

Keywords

amyloidosis; diphosphonates; heart failure; nuclear medicine; technetium

Hrčak ID:

280996

URI

https://hrcak.srce.hr/280996

Publication date:

1.9.2022.

Article data in other languages: croatian

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