Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK)
Systemic forms of amyloidosis affecting the heart are mostly light-chain (AL) and transthyretin (ATTR) amyloidoses. The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-in...
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Veröffentlicht in: | Clinical research in cardiology 2021-04, Vol.110 (4), p.479-506 |
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creator | Yilmaz, A. Bauersachs, J. Bengel, F. Büchel, R. Kindermann, I. Klingel, K. Knebel, F. Meder, B. Morbach, C. Nagel, E. Schulze-Bahr, E. aus dem Siepen, F. Frey, N. |
description | Systemic forms of amyloidosis affecting the heart are mostly light-chain (AL) and transthyretin (ATTR) amyloidoses. The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-invasive imaging techniques, such as cardiovascular magnetic resonance imaging (CMR) and scintigraphic methods, are available today. These imaging techniques do not only complement conventional echocardiography, but also allow for accurate assessment of the extent of cardiac involvement, in addition to diagnosing cardiac amyloidosis. Endomyocardial biopsy still plays a major role in the histopathological diagnosis and subtyping of cardiac amyloidosis. The main objective of the diagnostic algorithm outlined in this position statement is to detect cardiac amyloidosis as reliably and early as possible, to accurately determine its extent, and to reliably identify the underlying subtype of amyloidosis, thereby enabling subsequent targeted treatment. |
doi_str_mv | 10.1007/s00392-020-01799-3 |
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The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-invasive imaging techniques, such as cardiovascular magnetic resonance imaging (CMR) and scintigraphic methods, are available today. These imaging techniques do not only complement conventional echocardiography, but also allow for accurate assessment of the extent of cardiac involvement, in addition to diagnosing cardiac amyloidosis. Endomyocardial biopsy still plays a major role in the histopathological diagnosis and subtyping of cardiac amyloidosis. The main objective of the diagnostic algorithm outlined in this position statement is to detect cardiac amyloidosis as reliably and early as possible, to accurately determine its extent, and to reliably identify the underlying subtype of amyloidosis, thereby enabling subsequent targeted treatment.</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-020-01799-3</identifier><identifier>PMID: 33459839</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Algorithms ; Amyloidosis ; Biomarkers ; Biopsy ; Cardiology ; Conformation ; Diagnosis ; Echocardiography ; Heart ; Imaging techniques ; Magnetic resonance imaging ; Medical imaging ; Medicine ; Medicine & Public Health ; Review ; Transthyretin</subject><ispartof>Clinical research in cardiology, 2021-04, Vol.110 (4), p.479-506</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. 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Bauersachs, J. ; Bengel, F. ; Büchel, R. ; Kindermann, I. ; Klingel, K. ; Knebel, F. ; Meder, B. ; Morbach, C. ; Nagel, E. ; Schulze-Bahr, E. ; aus dem Siepen, F. ; Frey, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-11c61c9ffdb52832a53595261310c3f49bc8b2c26c81b52ecb16dd95c7f03d833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Algorithms</topic><topic>Amyloidosis</topic><topic>Biomarkers</topic><topic>Biopsy</topic><topic>Cardiology</topic><topic>Conformation</topic><topic>Diagnosis</topic><topic>Echocardiography</topic><topic>Heart</topic><topic>Imaging techniques</topic><topic>Magnetic resonance imaging</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Review</topic><topic>Transthyretin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yilmaz, A.</creatorcontrib><creatorcontrib>Bauersachs, J.</creatorcontrib><creatorcontrib>Bengel, F.</creatorcontrib><creatorcontrib>Büchel, R.</creatorcontrib><creatorcontrib>Kindermann, I.</creatorcontrib><creatorcontrib>Klingel, K.</creatorcontrib><creatorcontrib>Knebel, F.</creatorcontrib><creatorcontrib>Meder, B.</creatorcontrib><creatorcontrib>Morbach, C.</creatorcontrib><creatorcontrib>Nagel, E.</creatorcontrib><creatorcontrib>Schulze-Bahr, E.</creatorcontrib><creatorcontrib>aus dem Siepen, F.</creatorcontrib><creatorcontrib>Frey, N.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yilmaz, A.</au><au>Bauersachs, J.</au><au>Bengel, F.</au><au>Büchel, R.</au><au>Kindermann, I.</au><au>Klingel, K.</au><au>Knebel, F.</au><au>Meder, B.</au><au>Morbach, C.</au><au>Nagel, E.</au><au>Schulze-Bahr, E.</au><au>aus dem Siepen, F.</au><au>Frey, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK)</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>110</volume><issue>4</issue><spage>479</spage><epage>506</epage><pages>479-506</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Systemic forms of amyloidosis affecting the heart are mostly light-chain (AL) and transthyretin (ATTR) amyloidoses. The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-invasive imaging techniques, such as cardiovascular magnetic resonance imaging (CMR) and scintigraphic methods, are available today. These imaging techniques do not only complement conventional echocardiography, but also allow for accurate assessment of the extent of cardiac involvement, in addition to diagnosing cardiac amyloidosis. Endomyocardial biopsy still plays a major role in the histopathological diagnosis and subtyping of cardiac amyloidosis. 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subjects | Algorithms Amyloidosis Biomarkers Biopsy Cardiology Conformation Diagnosis Echocardiography Heart Imaging techniques Magnetic resonance imaging Medical imaging Medicine Medicine & Public Health Review Transthyretin |
title | Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK) |
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