Concomitant Cardiac Transthyretin Amyloidosis and Coronary Artery Disease---Imaging Features and Pitfalls

伴随性心脏转甲状腺素蛋白淀粉样变性和冠状动脉疾病——影像学特征和误诊陷阱

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Abstract

The coexistence of coronary artery disease (CAD) and transthyretin cardiac amyloidosis (ATTR-CM) is increasingly recognized in clinical practice, especially in older adults. Although each condition has distinct pathophysiologic and imaging features, their association could be challenging for interpretation of imaging and diagnosis. This report presents a series of clinical cases that illustrate multimodality imaging findings in patients with coexisting CAD and ATTR-CM. It highlights the unique and overlapping features seen on echocardiography, cardiac magnetic resonance imaging, nuclear imaging, and coronarography. Special attention is given to diagnosis challenges that arise when these conditions coexist, and to the value of recognizing atypical findings of both CAD and ATTR-CM. The objectives of this report are to: 1) raise awareness of the possibility of ATTR-CM in patients with known CAD; and 2) discuss several specific multi-imaging features and specific findings encountered in clinical cases with concomitant CAD and ATTR-CM.

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