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ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: Part 2 of 2—Diagnostic criteria and appropriate utilization

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Journal of Nuclear Cardiology Aims and scope

A Correction to this article was published on 19 July 2021

This article has been updated

Abstract

Cardiac amyloidosis is emerging as an underdiagnosed cause of heart failure and mortality. Growing literature suggests that a noninvasive diagnosis of cardiac amyloidosis is now feasible. However, the diagnostic criteria and utilization of imaging in cardiac amyloidosis are not standardized. In this paper, Part 2 of a series, a panel of international experts from multiple societies define the diagnostic criteria for cardiac amyloidosis and appropriate utilization of echocardiography, cardiovascular magnetic resonance imaging, and radionuclide imaging in the evaluation of patients with known or suspected cardiac amyloidosis.

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Abbreviations

AL:

Amyloid immunoglobulin light chains

ATTR:

Amyloid transthyretin

DPD:

99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid

EF:

Ejection fraction

HMDP:

Hydroxymethylenediphosphonate

LV:

Left ventricular

PYP:

Pyrophosphate

Tc:

99mTechnetium

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Acknowledgments

We would like to thank the reviewers of this document for their input, which has significantly improved the quality of this document, including Renée P. Bullock-Palmer, MD, FACC, FASNC, FASE, FSCCT; Dennis A. Calnon, MD, FASNC; Marcelo F. Di Carli, MD; Martha Grogan, MD; Phillip Hawkins, PhD, FMedSci; Wael A. Jaber, MD, FACC, FAHA; Prem Soman, MD, FASNC; James E. Udelson, MD, FACC; Ashutosh D. Wechalekar, DM, MRCP, FRCPath.

Author information

Authors and Affiliations

  1. Cardiac Amyloidosis Program, Cardiovascular Imaging Program, Departments of Radiology and Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Sharmila Dorbala MD, MPH, FASNC (Chair), Rodney H. Falk MD & Raymond Y. Kwong MD, MPH

  2. Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Yukio Ando MD, PhD

  3. Columbia University Medical Center, Columbia University Medical Center/New York Presbyterian Hospital, Columbia University, New York, NY, USA

    Sabahat Bokhari MD & Mathew S. Maurer MD

  4. Divisions of Hematology and Cardiovascular Diseases, Department of Radiology, Division of Nuclear Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Angela Dispenzieri MD

  5. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Victor A. Ferrari MD

  6. Division of Medicine, National Amyloidosis Centre, University College London, London, United Kingdom

    Marianna Fontana PhD, Julian D. Gillmore MD, PhD, James C. Moon MD & C. Cristina Quarta MD, PhD

  7. Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium

    Olivier Gheysens MD, PhD

  8. Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Andor W. J. M. Glaudemans MD, PhD & Riemer H. J. A. Slart MD

  9. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA

    Mazen A. Hanna MD

  10. Department of Rheumatology & Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Bouke P. C. Hazenberg MD, PhD

  11. Department of Cardiology, University of Heidelberg, Heidelberg, Germany

    Arnt V. Kristen MD

  12. Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy

    Giampaolo Merlini MD

  13. Department of Molecular Medicine, University of Pavia, Pavia, Italy

    Giampaolo Merlini MD

  14. Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA

    Edward J. Miller MD, PhD

  15. Frankel Cardiovascular Center, Michigan Medicine, Ann Arbor, MI, USA

    Venkatesh L. Murthy MD, PhD

  16. Cardiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater-University of Bologna, Bologna, Italy

    Claudio Rapezzi MD

  17. Amyloidosis Center and Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA

    Frederick L. Ruberg MD

  18. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Sanjiv J. Shah MD

  19. Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Hein J. Verberne MD, PhD

  20. Cardiovascular Imaging Center, Departments of Medicine and Radiology, University of Virginia, Charlottesville, VA, USA

    Jamieson M. Bourque MD, MHS, FASNC (Co-Chair)

Authors
  1. Sharmila Dorbala MD, MPH, FASNC (Chair)
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  2. Yukio Ando MD, PhD
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  3. Sabahat Bokhari MD
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  4. Angela Dispenzieri MD
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  5. Rodney H. Falk MD
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  6. Victor A. Ferrari MD
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  7. Marianna Fontana PhD
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  8. Olivier Gheysens MD, PhD
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  9. Julian D. Gillmore MD, PhD
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  10. Andor W. J. M. Glaudemans MD, PhD
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  11. Mazen A. Hanna MD
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  12. Bouke P. C. Hazenberg MD, PhD
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  13. Arnt V. Kristen MD
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  14. Raymond Y. Kwong MD, MPH
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  15. Mathew S. Maurer MD
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  16. Giampaolo Merlini MD
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  17. Edward J. Miller MD, PhD
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  18. James C. Moon MD
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  19. Venkatesh L. Murthy MD, PhD
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  20. C. Cristina Quarta MD, PhD
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  21. Claudio Rapezzi MD
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  22. Frederick L. Ruberg MD
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  23. Sanjiv J. Shah MD
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  24. Riemer H. J. A. Slart MD
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  25. Hein J. Verberne MD, PhD
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  26. Jamieson M. Bourque MD, MHS, FASNC (Co-Chair)
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Corresponding author

Correspondence to Sharmila Dorbala MD, MPH, FASNC (Chair).

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Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is being jointly published in the Journal of Nuclear Cardiology, Journal of Cardiac Failure, and Circulation: Cardiovascular Imaging.

Part 1 – Evidence Base and Standardized Methods of Imaging is available at https://doi.org/10.1007/s12350-019-01760-6.

This document was approved for publication by the governing body of the American Society of Nuclear Cardiology (ASNC) and was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), American Society of Echocardiography (ASE), the European Association of Nuclear Medicine (EANM), the Heart Failure Society of America (HFSA), the International Society of Amyloidosis (ISA), the Society for Cardiovascular Magnetic Resonance (SCMR), and the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

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Dorbala, S., Ando, Y., Bokhari, S. et al. ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: Part 2 of 2—Diagnostic criteria and appropriate utilization. J. Nucl. Cardiol. 27, 659–673 (2020). https://doi.org/10.1007/s12350-019-01761-5

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