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Transthyretin Cardiac Amyloidosis in Older Adults: Optimizing Cardiac Imaging to the Corresponding Diagnostic and Management Goal

  • Elder and Heart Disease (K. Dharmarajan, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Transthyretin cardiac amyloidosis is increasingly recognized as an important cause of heart failure in older adults. Many cardiac imaging modalities have evolved to evaluate transthyretin cardiac amyloidosis and include 2D echocardiography with tissue Doppler and speckle-strain imaging, nuclear scintigraphy, cardiac magnetic resonance imaging, and positron emission tomography. The purpose of this review is to highlight the optimal selection of advanced cardiac imaging techniques with corresponding diagnostic goals including raising suspicion, making an early diagnosis, and subtyping transthyretin cardiac amyloid, as well as management goals including assessment of ventricular impairment, prognosticating, and monitoring disease progression. Potential benefits of optimizing cardiac imaging in the elderly patient with transthyretin cardiac amyloidosis may include enhanced and earlier diagnosis and refined long-term management.

Recent Findings

Advances in cardiac imaging techniques are changing diagnostic and management algorithms for transthyretin cardiac amyloidosis.

Summary

With a new era of novel therapeutics, enhanced recognition, and earlier diagnosis approaching, selecting the appropriate non-invasive cardiac imaging modality will be essential for optimal care in the elderly patient with transthyretin cardiac amyloidosis.

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Authors and Affiliations

  1. Division of Cardiology, Center for Advanced Cardiac Care, Laboratory of Nuclear Cardiology, Columbia University College of Physicians & Surgeons, New York, NY, 10032-3784, USA

    Adam Castaño, Daniel K. Manson, Mathew S. Maurer & Sabahat Bokhari

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  1. Adam Castaño
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  2. Daniel K. Manson
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  3. Mathew S. Maurer
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  4. Sabahat Bokhari
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Correspondence to Adam Castaño.

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Conflict of Interest

Dr. Adam Castaño received salary support from the ACC/Merck Fellowship in Cardiovascular Disease and the New York Academy of Medicine Glorney-Raisbeck Fellowship in Cardiovascular Disease.

Dr. Manson declares no conflicts of interests.

Dr. Mathew S. Maurer receives funding from an NIH K24 AG036778 Midcareer Mentoring Award in Geriatric Cardiology and his institution receives funding for research and serving on advisory boards and DSMBs from Pfizer Inc., Alnylam Pharmaceuticals Inc., ISIS Pharmaceuticals, and Prothena Inc.

Dr. Bokhari declares no conflicts of interests.

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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 Elder and Heart Disease

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Castaño, A., Manson, D.K., Maurer, M.S. et al. Transthyretin Cardiac Amyloidosis in Older Adults: Optimizing Cardiac Imaging to the Corresponding Diagnostic and Management Goal. Curr Cardiovasc Risk Rep 11, 17 (2017). https://doi.org/10.1007/s12170-017-0541-x

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