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Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis?

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
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Abstract

Purpose of Review

Nuclear imaging recently gained a key role in the diagnosis and prognostic assessment of transthyretin (TTR)-related cardiac amyloidosis. This review aims at summarizing the state-of-the art regarding the implementation of nuclear imaging in the management of hereditary mutated TTR-cardiac amyloidosis (mTTR-CA).

Recent Findings

Although cardiac uptake of bone tracers is acknowledged as a specific marker of TTR amyloid cardiac burden, recent studies validated the implementation of bone scan in the flow chart for non-invasive diagnosis and follow-up of CA in multicenter trials. Simultaneously, cardiac denervation evidenced by MIBG scintigraphy proved to be a strong and independent prognostic marker of poor outcome in mTTR-CA.

Summary

By its unique ability to assess both amyloid burden and cardiac denervation, nuclear imaging may prove useful as part of multimodality imaging tools to trigger treatment initiation and monitoring in patients with mTTR-CA.

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Acknowledgements

The study has been supported by the Association Française Contre l'Amylose.

Author information

Authors and Affiliations

  1. Cardiology Department, Antoine Béclère Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), UMR-S 1180, University of Paris-Sud, Clamart, France

    Vincent Algalarrondo, Ludivine Eliahou & Michel S. Slama

  2. French Referral Center for Familial Amyloidotic Polyneuropathy and Other Rare Peripheral Neuropathies (CRMR-NNERF), Bicêtre, France

    Vincent Algalarrondo, Ludivine Eliahou & Michel S. Slama

  3. Nuclear Medicine Department and DHU FIRE, Bichat Claude Bernard Hospital, AP-HP, University Paris VII, Paris, France

    Eve Piekarski, Dominique Le Guludec & François Rouzet

  4. Inserm UMR-S 1148, Paris, France

    Eve Piekarski, Dominique Le Guludec & François Rouzet

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  1. Vincent Algalarrondo
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  2. Eve Piekarski
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  3. Ludivine Eliahou
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  4. Dominique Le Guludec
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Corresponding author

Correspondence to François Rouzet.

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Conflict of Interest

Eve Piekarski and Ludivine Eliahou declare that they have no conflict of interest.

Vincent Algalarrondo reports grants from Medtronic, St. Jude Medical, Sorin, and Boston Scientific.

François Rouzet reports grants from Alnylam and General Electrics.

Dominique Le Guludec reports grants from GE Healthcare, Alnylam, and Advanced Accelerator Application.

Michel S. Slama has received consulting fees from Pfizer, Alnylam, and Eidos, and his department has received a grant from Ionis-GSK.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Nuclear Cardiology

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Algalarrondo, V., Piekarski, E., Eliahou, L. et al. Can Nuclear Imaging Techniques Predict Patient Outcome and Guide Medical Management in Hereditary Transthyretin Cardiac Amyloidosis?. Curr Cardiol Rep 20, 33 (2018). https://doi.org/10.1007/s11886-018-0976-9

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  • DOI: https://doi.org/10.1007/s11886-018-0976-9

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