Tipo di tesi
Tesi di laurea magistrale LM6
Titolo
Role of Computed Tomography Imaging in patients with suspected Cardiac Amyloidosis: preliminary results from the MYOAMY study
Dipartimento
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Parole chiave
- cardiac amyloidosis
- cardiac hypertrophy
- cardiomyopathy
- computed tomograpgy
- diagnosis
- imaging
- MYOAMY
Data inizio appello
23/06/2026
Consultabilità
Non consultabile
Data di rilascio
23/06/2029
Riassunto (Inglese)
Cardiac amyloidosis (CA) is a recognized cause of heart failure. The differentiation between transthyretin (ATTR) and light chain amyloidosis, as well as from other hypertrophic phenotypes, is crucial. Cardiac computed tomography (CT) represents a poorly investigated technology. We aimed to evaluate the diagnostic and clinical value of CT, including extracellular volume (ECV) quantification and late iodine enhancement (LIE), in suspected or diagnosed CA.
We conducted a prospective multi-center study enrolling 90 consecutive patients with suspected CA or recent diagnosis. All subjects underwent a comprehensive CT protocol including coronary imaging and spectral acquisition at 3, 5, 7, and 10 minutes post-contrast. We assessed the diagnostic accuracy of ECV-CT at different time points, the agreement between LIE and cardiac magnetic resonance-derived (CMR) late gadolinium enhancement (LGE), and the prevalence of coronary artery disease (CAD).
CA was confirmed in 73 patients (81%). ECV-CT at 3 minutes yielded the highest diagnostic accuracy (AUC: 0.79) with an optimal cut-off of 35%. LIE showed moderate agreement with CMR-LGE (Cohen’s K: 0.47; positive predictive value: 100%). CT identified severe CAD in 24% of CA patients and detected extracardiac findings in a significant proportion of patients, serving as a "one-stop-shop" tool.
ECV-CT quantification and LIE provide high diagnostic accuracy, comparable to CMR, simultaneously screening for coronary and extracardiac pathologies.
