Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Heart Failure Reviews
Published in: Heart Failure Reviews 5/2022

07-11-2021 | Cardiac Amyloidosis

The utility of positron emission tomography in cardiac amyloidosis

Authors: Subha Saeed, Jean Michel Saad, Ahmed Ibrahim Ahmed, Yushui Han, Mouaz H. Al-Mallah

Published in: Heart Failure Reviews | Issue 5/2022

Login to get access

Abstract

Cardiac amyloidosis, characterized by progressive restrictive cardiomyopathy, presents unusual diagnostic challenges. Conventional cardiac scintigraphy has shown limited utility in the quantification of disease burden and serial follow-up of cardiac amyloidosis. The advent of specialized positron emission tomography with specific amyloid-binding radiotracers has the potential to change currently employed diagnostic algorithms for the imaging of cardiac amyloidosis. This review aims to discuss the diagnostic utility of amyloid-binding radiotracers, including Pittsburg compound B, florbetapir, florbetapan, and sodium fluoride. These tracers have promising potential for the early detection of the particular type of cardiac amyloidosis, pursuing relevant medical intervention, assessing amyloid burden, monitoring treatment response, and overall prognostication.
Appendix
Available only for authorised users
Literature
1.
2.
Phelan D et al (2012) Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis. Heart 98(19):1442–1448PubMedCrossRef
3.
Syed IS et al (2010) Role of cardiac magnetic resonance imaging in the detection of cardiac amyloidosis. JACC Cardiovasc Imaging 3(2):155–164PubMedCrossRef
4.
Kristen AV, Dengler TJ, Katus HA (2007) Suspected cardiac amyloidosis: endomyocardial biopsy remains the diagnostic gold-standard. Am J Hematol 82(4):328PubMedCrossRef
5.
6.
Lee SP et al (2020) Pittsburgh B compound positron emission tomography in patients with AL cardiac amyloidosis. J Am Coll Cardiol 75(4):380–390PubMedCrossRef
7.
8.
9.
Perugini E et al (2005) Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy. J Am Coll Cardiol 46(6):1076–1084PubMedCrossRef
10.
11.
Castaño A, Bokhari S, Maurer MS (2015) Unveiling wild-type transthyretin cardiac amyloidosis as a significant and potentially modifiable cause of heart failure with preserved ejection fraction. Eur Heart J 36(38):2595–2597PubMedCrossRef
12.
Gillmore JD et al (2016) Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 133(24):2404–2412PubMedCrossRef
13.
Dorbala S et al (2019) ASNC/AHA/ASE/EANM/HFSA/ISA/SCMR/SNMMI expert consensus recommendations for multimodality imaging in cardiac amyloidosis: part 1 of 2—evidence base and standardized methods of imaging. J Nucl Cardiol 26(6):2065–2123PubMedCrossRef
14.
Rosengren S et al (2020) Diagnostic accuracy of [11C]PIB positron emission tomography for detection of cardiac amyloidosis. JACC Cardiovasc Imaging 13(6):1337–1347PubMedCrossRef
15.
Cuddy SAM et al (2020) Improved quantification of cardiac amyloid burden in systemic light chain amyloidosis: redefining early disease? JACC Cardiovasc Imaging 13(6):1325–1336PubMedPubMedCentralCrossRef
16.
Castaño A et al (2016) Serial scanning with technetium pyrophosphate (99mTc-PYP) in advanced ATTR cardiac amyloidosis. Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology 23(6):1355–1363CrossRef
17.
Klunk WE et al (2004) Imaging brain amyloid in Alzheimer’s disease with Pittsburgh compound-B. Ann Neurol 55(3):306–319PubMedCrossRef
18.
Antoni G et al (2013) In vivo visualization of amyloid deposits in the heart with 11C-PIB and PET. J Nucl Med 54(2):213–220PubMedCrossRef
19.
Ezawa N et al (2018) Visualization of multiple organ amyloid involvement in systemic amyloidosis using (11)C-PiB PET imaging. Eur J Nucl Med Mol Imaging 45(3):452–461PubMedCrossRef
20.
Lee SP et al (2015) 11C-Pittsburgh B PET imaging in cardiac amyloidosis. JACC Cardiovasc Imaging 8(1):50–59PubMedCrossRef
21.
Kristen AV et al (2016) Cardiac amyloid load: a prognostic and predictive biomarker in patients with light-chain amyloidosis. J Am Coll Cardiol 68(1):13–24PubMedCrossRef
22.
Pilebro B et al (2018) Positron emission tomography (PET) utilizing Pittsburgh compound B (PIB) for detection of amyloid heart deposits in hereditary transthyretin amyloidosis (ATTR). J Nucl Cardiol 25(1):240–248PubMedCrossRef
23.
Koike H et al (2004) Pathology of early- vs late-onset TTR Met30 familial amyloid polyneuropathy. Neurology 63(1):129–138PubMedCrossRef
24.
Takasone K et al (2020) Non-invasive detection and differentiation of cardiac amyloidosis using (99m)Tc-pyrophosphate scintigraphy and (11)C-Pittsburgh compound B PET imaging. Amyloid 27(4):266–274PubMedCrossRef
25.
Rosengren S et al (2020) Diagnostic accuracy of [(11)C]PIB positron emission tomography for detection of cardiac amyloidosis. JACC Cardiovasc Imaging 13(6):1337–1347PubMedCrossRef
26.
Choi SR et al (2012) Correlation of amyloid PET ligand florbetapir F 18 binding with Aβ aggregation and neuritic plaque deposition in postmortem brain tissue. Alzheimer Dis Assoc Disord 26(1):8–16PubMedPubMedCentralCrossRef
27.
Ni R et al (2013) Amyloid tracers detect multiple binding sites in Alzheimer’s disease brain tissue. Brain 136(7):2217–2227PubMedCrossRef
28.
Clark CM et al (2012) Cerebral PET with florbetapir compared with neuropathology at autopsy for detection of neuritic amyloid-β plaques: a prospective cohort study. Lancet Neurol 11(8):669–678PubMedCrossRef
29.
Park MA et al (2015) 18F-Florbetapir binds specifically to myocardial light chain and transthyretin amyloid deposits: autoradiography study. Circ Cardiovasc Imag 8(8)
30.
Dorbala S et al (2014) Imaging cardiac amyloidosis: a pilot study using 18F-florbetapir positron emission tomography. Eur J Nucl Med Mol Imaging 41(9):1652-1662
31.
Osborne DR et al (2015) A routine PET/CT protocol with streamlined calculations for assessing cardiac amyloidosis using (18)F-florbetapir. Front Cardiovasc Med 2:23PubMedPubMedCentralCrossRef
32.
Manwani R et al (2018) A pilot study demonstrating cardiac uptake with 18F-florbetapir PET in AL amyloidosis patients with cardiac involvement. Amyloid 25(4):247–252PubMedCrossRef
33.
34.
Law WP et al (2016) Cardiac amyloid imaging with 18F-florbetaben PET: a pilot study. J Nucl Med 57(11):1733–1739PubMedCrossRef
35.
Kircher M et al (2019) Detection of cardiac amyloidosis with (18)F-florbetaben-PET/CT in comparison to echocardiography, cardiac MRI and DPD-scintigraphy. Eur J Nucl Med Mol Imaging 46(7):1407–1416PubMedCrossRef
36.
Seo M et al (2019) Clinical utility of 18F-florbetaben PET for detecting amyloidosis associated with multiple myeloma: a prospective case-control study. Clin Nucl Med 44(9):e503–e509PubMedCrossRef
37.
Genovesi D et al (2021) [18F]-Florbetaben PET/CT for differential diagnosis among cardiac immunoglobulin light chain, transthyretin amyloidosis, and mimicking conditions. JACC Cardiovasc Imaging 14(1):246–255PubMedCrossRef
38.
Van Der Gucht A et al (2016) [18F]-NaF PET/CT imaging in cardiac amyloidosis. Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology 23(4):846–849CrossRef
39.
Gagliardi C et al (2017) Does the etiology of cardiac amyloidosis determine the myocardial uptake of [18F]-NaF PET/CT? Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology 24(2):746–749CrossRef
40.
Morgenstern R et al (2018) 18Fluorine sodium fluoride positron emission tomography, a potential biomarker of transthyretin cardiac amyloidosis. Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology 25(5):1559–1567CrossRef
41.
42.
Abulizi M et al (2019) 18F-Sodium fluoride PET/MRI myocardial imaging in patients with suspected cardiac amyloidosis. J Nuc Cardiol: Official Pub Am Soc Nuclear Cardiol
43.
Martineau P et al (2021) Examining the sensitivity of 18F-NaF PET for the imaging of cardiac amyloidosis. Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology 28(1):209–218CrossRef
44.
Masri A et al (2020) Molecular imaging of cardiac amyloidosis. Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine 61(7):965–970CrossRef
45.
Kim SH, Kim YS, Kim S-J (2020) Diagnostic performance of PET for detection of cardiac amyloidosis: a systematic review and meta-analysis. J Cardiol 76(6):618–625PubMedCrossRef
46.
47.
Bravo PE, Di Carli MF, Dorbala S (2017) Role of PET to evaluate coronary microvascular dysfunction in non-ischemic cardiomyopathies. Heart Fail Rev 22(4):455–464PubMedPubMedCentralCrossRef
48.
Camici PG, d’Amati G, Rimoldi O (2015) Coronary microvascular dysfunction: mechanisms and functional assessment. Nat Rev Cardiol 12(1):48–62PubMedCrossRef
49.
Tsai SB et al (2011) Myocardial infarction with “clean coronaries” caused by amyloid light-chain AL amyloidosis: a case report and literature review. Amyloid: The Int J Exp Clinical Investigation: The Official J Int Soc Amyloidosis 18(3):160–164
50.
Al Suwaidi J et al (1999) Systemic amyloidosis presenting with angina pectoris. Ann Intern Med 131(11):838–841PubMedCrossRef
51.
Ogawa H et al (2001) Cardiac amyloidosis presenting as microvascular angina–a case report. Angiology 52(4):273–278PubMedCrossRef
52.
Smith RR, Hutchins GM (1979) Ischemic heart disease secondary to amyloidosis of intramyocardial arteries. Am J Cardiol 44(3):413–417PubMedCrossRef
53.
Hongo M et al (2000) Comparison of electrocardiographic findings in patients with AL (primary) amyloidosis and in familial amyloid polyneuropathy and anginal pain and their relation to histopathologic findings. Am J Cardiol 85(7):849–853PubMedCrossRef
54.
Modesto KM et al (2007) Vascular abnormalities in primary amyloidosis. Eur Heart J 28(8):1019–1024PubMedCrossRef
55.
Buja LM, Khoi NB, Roberts WC (1970) Clinically significant cardiac amyloidosis. Clinicopathologic findings in 15 patients. The Am J Cardiol 26(4):94–405
56.
Dorbala S et al (2014) Coronary microvascular dysfunction is related to abnormalities in myocardial structure and function in cardiac amyloidosis. JACC Heart failure 2(4):358–367PubMedPubMedCentralCrossRef
57.
Takasone K et al (2020) Non-invasive detection and differentiation of cardiac amyloidosis using 99mTc-pyrophosphate scintigraphy and 11C-Pittsburgh compound B PET imaging. Amyloid 27(4):266–274PubMedCrossRef
Metadata
Title
The utility of positron emission tomography in cardiac amyloidosis
Authors
Subha Saeed
Jean Michel Saad
Ahmed Ibrahim Ahmed
Yushui Han
Mouaz H. Al-Mallah
Publication date
07-11-2021
Publisher
Springer US
Published in
Heart Failure Reviews / Issue 5/2022
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-021-10183-w

Other articles of this Issue 5/2022

Heart Failure Reviews 5/2022 Go to the issue

ReviewPaper

Echocardiographic assessment of cardiac amyloidosis

ReviewPaper

Immunity and inflammation: the neglected key players in congenital heart disease?

ReviewPaper

Detection of myocardial fibrosis by speckle-tracking echocardiography: from prediction to clinical applications

ReviewPaper

Creatine deficiency and heart failure

ReviewPaper

Mechanisms, time course and predictability of premature ventricular contractions cardiomyopathy—an update on its development and resolution

ReviewPaper

State-of-the-art review on management of end-stage heart failure in amyloidosis: transplant and beyond

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits