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Multi-Modality Cardiovascular Imaging Assessment in Fabry Disease

Roy, A, Mansour, M, Oxborough, D, Geberhiwot, T and Steeds, R (2022) Multi-Modality Cardiovascular Imaging Assessment in Fabry Disease. Applied Sciences, 12 (3). ISSN 2076-3417

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Open Access URL: https://doi.org/10.3390/app12031605 (Published Version)

Abstract

Fabry disease (FD) is a rare X-linked lysosomal storage disorder manifesting as progressive multi-organ accumulation of sphingolipids due to deficiency in the enzyme α-Galactosidase A. Sphingolipid accumulation can take place in all cardiac cell types which manifests as left ventricular hypertrophy, microvascular ischaemia, conduction abnormalities, arrhythmia, heart failure, and valvular disease. The use of advanced cardiovascular imaging techniques have enabled clinicians to stage and prognosticate the disease and guide therapy. Transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) in conjunction are the hallmark imaging modalities to allow for this assessment. Traditionally, the assessment of cardiac involvement in FD was based on the assessment of maximal wall thickness (MWT) and the development of left ventricular hypertrophy (LVH). It is now understood that sphingolipid accumulation takes place before the development of LVH. Advances in techniques within TTE and CMR, particularly that of strain assessment and T1/T2 mapping, have meant that Fabry cardiomyopathy (FCM) can be diagnosed earlier in the disease process. This potentially provides a window for initiation of enzyme replacement therapy (ERT) at a stage where it is likely to have the most beneficial effect in reducing the high mortality associated with FCM. This review outlines the advances in multimodality imaging in staging and prognosticating FCM, as well as the applications of cardiac imaging in assessing symptoms and complications of FCM.

Item Type: Article
Uncontrolled Keywords: artificial intelligence; CARDIAC INVOLVEMENT; cardiac magnetic resonance Imaging; cardiomyopathy; Chemistry; Chemistry, Multidisciplinary; DIASTOLIC FUNCTION; Engineering; Engineering, Multidisciplinary; ENZYME REPLACEMENT THERAPY; Fabry disease; LEFT-VENTRICULAR HYPERTROPHY; MAGNETIC-RESONANCE; Materials Science; Materials Science, Multidisciplinary; MYOCARDIAL FIBROSIS; Physical Sciences; Physics; Physics, Applied; PULMONARY INVOLVEMENT; Science & Technology; SUDDEN-DEATH; Technology; TISSUE DOPPLER; transthoracic echocardiography; WALL THICKNESS MEASUREMENT; Science & Technology; Physical Sciences; Technology; Chemistry, Multidisciplinary; Engineering, Multidisciplinary; Materials Science, Multidisciplinary; Physics, Applied; Chemistry; Engineering; Materials Science; Physics; Fabry disease; cardiomyopathy; transthoracic echocardiography; cardiac magnetic resonance Imaging; artificial intelligence; ENZYME REPLACEMENT THERAPY; LEFT-VENTRICULAR HYPERTROPHY; WALL THICKNESS MEASUREMENT; MAGNETIC-RESONANCE; DIASTOLIC FUNCTION; TISSUE DOPPLER; PULMONARY INVOLVEMENT; MYOCARDIAL FIBROSIS; CARDIAC INVOLVEMENT; SUDDEN-DEATH
Subjects: Q Science > Q Science (General)
Q Science > QP Physiology
G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports
Divisions: Sport & Exercise Sciences
Publisher: MDPI AG
SWORD Depositor: A Symplectic
Date Deposited: 21 Dec 2022 10:28
Last Modified: 21 Dec 2022 10:28
DOI or ID number: 10.3390/app12031605
URI: https://researchonline.ljmu.ac.uk/id/eprint/18457
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