Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis
Method: Use the PICO format to generate a series of questions, focusing on the specificity and sensitivity of the amyloidosis diagnostic test. PubMed searches were conducted in English and Spanish from July to August 2019. The level of evidence and recommendation are based on the GRADE system (http:...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/30897 |
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Universidad Nacional de Córdoba |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
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Artículo revista |
| topic |
amyloidosis diagnosis amyloidosis inmunoglobulin light-chain amyloidosis amyloidosis, familial amiloidosis diagnóstico amiloidosis de cadenas ligeras de las inmunoglobulinas amiloidosis familiar amiloidose diagnóstico amiloidose familiar amiloidose de cadeia leve de imunoglobulina |
| spellingShingle |
amyloidosis diagnosis amyloidosis inmunoglobulin light-chain amyloidosis amyloidosis, familial amiloidosis diagnóstico amiloidosis de cadenas ligeras de las inmunoglobulinas amiloidosis familiar amiloidose diagnóstico amiloidose familiar amiloidose de cadeia leve de imunoglobulina Posadas Martinez, Maria Lourdes Nucifora, Elsa Belziti, Cesar Auteri, Miguel Angel Pitzus, Ariel Edgardo Dragonetti, Laura Perez de Arenaza, Diego Peuchot, Verónica Aguirre, María Adela Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis |
| topic_facet |
amyloidosis diagnosis amyloidosis inmunoglobulin light-chain amyloidosis amyloidosis, familial amiloidosis diagnóstico amiloidosis de cadenas ligeras de las inmunoglobulinas amiloidosis familiar amiloidose diagnóstico amiloidose familiar amiloidose de cadeia leve de imunoglobulina |
| author |
Posadas Martinez, Maria Lourdes Nucifora, Elsa Belziti, Cesar Auteri, Miguel Angel Pitzus, Ariel Edgardo Dragonetti, Laura Perez de Arenaza, Diego Peuchot, Verónica Aguirre, María Adela |
| author_facet |
Posadas Martinez, Maria Lourdes Nucifora, Elsa Belziti, Cesar Auteri, Miguel Angel Pitzus, Ariel Edgardo Dragonetti, Laura Perez de Arenaza, Diego Peuchot, Verónica Aguirre, María Adela |
| author_sort |
Posadas Martinez, Maria Lourdes |
| title |
Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis |
| title_short |
Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis |
| title_full |
Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis |
| title_fullStr |
Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis |
| title_full_unstemmed |
Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis |
| title_sort |
clinical practice guidelines for diagnosis of organic involvement of amyloidosis: part 2/3.year 2020: cpg organic damage in amyloidosis |
| description |
Method: Use the PICO format to generate a series of questions, focusing on the specificity and sensitivity of the amyloidosis diagnostic test. PubMed searches were conducted in English and Spanish from July to August 2019. The level of evidence and recommendation are based on the GRADE system (http://www.gradeworkinggroup.org/index.htm). The recommendations are graded according to their direction (for or against) and strength (strong and weak). Finally, it is recommended to use GLIA tools to evaluate the obstacles and facilitators in implementation.
Suggested explanation: A strong suggestion indicates a high degree of trust in support or opposition to the intervention. When defining a strong recommendation, this guide uses the "recommended" language. The weaker recommendations indicate that the outcome of the intervention (favorable or unfavorable) is doubtful. In this case, if a weak recommendation is defined, the "recommendation" language is used.
How to use these guidelines: Recommendations must be explained within the scope of special care in validated diagnostic studies conducted by specially trained doctors. It is not assumed to change the coexistence conditions of the disease process. Presumably, the attending physician has a high degree of suspicion of amyloidosis. It assumes that diagnostic research is conducted by well-trained doctors using a validated standardized method. This guide is intended for health care professionals and those involved in health care policies to help ensure that the necessary agreements have been reached to provide appropriate care.
Summary of recommendations
For patients with suspected amyloidosis, it is recommended:
● Electrocardiogram be used as a preliminary assessment for all patients with amyloidosis.
Doppler echocardiography conventional be used as the initial image of the first choice for cardiac amyloidosis in patients diagnosed with suspected heart involvement due to amyloidosis.
Echocardiographic strain diagnosis for patients with amyloidosis prompted by conventional echocardiography or uncertain.
Cardiac magnetic resonance imaging (MRI) be used for the diagnosis of cardiac amyloidosis in patients with previous studies suggesting or uncertain amyloidosis.
T1 mapping technology for cardiac MRI to diagnose myocardial amyloidosis as an alternative to MRI, for patients with kidney failure or contraindication to other studies
Cardiac MRI examination with T1 localization technique for patients who have previously studied amyloidosis, and measure the extracellular volume and quantify the degree of cardiac involvement in order to diagnose and measure the cardiac involvement caused by amyloidosis.
It is suggested:
Cardiac MRI with T1 mapping technique and extracellular volume measurement for the early diagnosis of amyloidosis in patients with previous studies suggestive of amyloidosis.
Measurement of type B-type natriuretic peptide measurement be used for screening and diagnosis of cardiac amyloidosis.
Pyrophosphate scintigraphy to make a preliminary diagnosis of patients with suspected cardiac amyloidosis, so as to distinguish ATTR (positive) from other patients.
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2022 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/30897 |
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I10-R327-article-308972022-06-06T11:18:17Z Clinical Practice Guidelines for diagnosis of organic involvement of amyloidosis: Part 2/3.Year 2020: CPG organic damage in amyloidosis Guía de Práctica Clínica para el diagnóstico de compromiso orgánico de amiloidosis: Parte 2/3 . Año 2020: GPC compromiso orgánico en amiloidosis Guia de prática clínica para o diagnóstico de envolvimento orgânico da amiloidose: Parte 2/3 Ano 2020: GPC compromisso orgânico na amiloidose Posadas Martinez, Maria Lourdes Nucifora, Elsa Belziti, Cesar Auteri, Miguel Angel Pitzus, Ariel Edgardo Dragonetti, Laura Perez de Arenaza, Diego Peuchot, Verónica Aguirre, María Adela amyloidosis diagnosis amyloidosis inmunoglobulin light-chain amyloidosis amyloidosis, familial amiloidosis diagnóstico amiloidosis de cadenas ligeras de las inmunoglobulinas amiloidosis familiar amiloidose diagnóstico amiloidose familiar amiloidose de cadeia leve de imunoglobulina Method: Use the PICO format to generate a series of questions, focusing on the specificity and sensitivity of the amyloidosis diagnostic test. PubMed searches were conducted in English and Spanish from July to August 2019. The level of evidence and recommendation are based on the GRADE system (http://www.gradeworkinggroup.org/index.htm). The recommendations are graded according to their direction (for or against) and strength (strong and weak). Finally, it is recommended to use GLIA tools to evaluate the obstacles and facilitators in implementation. Suggested explanation: A strong suggestion indicates a high degree of trust in support or opposition to the intervention. When defining a strong recommendation, this guide uses the "recommended" language. The weaker recommendations indicate that the outcome of the intervention (favorable or unfavorable) is doubtful. In this case, if a weak recommendation is defined, the "recommendation" language is used. How to use these guidelines: Recommendations must be explained within the scope of special care in validated diagnostic studies conducted by specially trained doctors. It is not assumed to change the coexistence conditions of the disease process. Presumably, the attending physician has a high degree of suspicion of amyloidosis. It assumes that diagnostic research is conducted by well-trained doctors using a validated standardized method. This guide is intended for health care professionals and those involved in health care policies to help ensure that the necessary agreements have been reached to provide appropriate care. Summary of recommendations For patients with suspected amyloidosis, it is recommended: ● Electrocardiogram be used as a preliminary assessment for all patients with amyloidosis. Doppler echocardiography conventional be used as the initial image of the first choice for cardiac amyloidosis in patients diagnosed with suspected heart involvement due to amyloidosis. Echocardiographic strain diagnosis for patients with amyloidosis prompted by conventional echocardiography or uncertain. Cardiac magnetic resonance imaging (MRI) be used for the diagnosis of cardiac amyloidosis in patients with previous studies suggesting or uncertain amyloidosis. T1 mapping technology for cardiac MRI to diagnose myocardial amyloidosis as an alternative to MRI, for patients with kidney failure or contraindication to other studies Cardiac MRI examination with T1 localization technique for patients who have previously studied amyloidosis, and measure the extracellular volume and quantify the degree of cardiac involvement in order to diagnose and measure the cardiac involvement caused by amyloidosis. It is suggested: Cardiac MRI with T1 mapping technique and extracellular volume measurement for the early diagnosis of amyloidosis in patients with previous studies suggestive of amyloidosis. Measurement of type B-type natriuretic peptide measurement be used for screening and diagnosis of cardiac amyloidosis. Pyrophosphate scintigraphy to make a preliminary diagnosis of patients with suspected cardiac amyloidosis, so as to distinguish ATTR (positive) from other patients. Métodos: Se generó un listado de preguntas con el formato PICO centradas en la especificidad y sensibilidad de las pruebas diagnósticas en amiloidosis. Se realizó la búsqueda en PubMed durante julio-agosto del 2019, en inglés y español. Los niveles de evidencia y los grados de recomendación se basan en el sistema GRADE (http://www.gradeworkinggroup.org/index.htm). Las recomendaciones se graduaron según su dirección (a favor o en contra) y según fuerza (fuertes y débiles). Las recomendaciones finales fueron evaluadas con la herramienta GLIA para barreras y facilitadores en la implementación de éstas. Interpretación de recomendaciones: Las recomendaciones fuertes indican alta confianza, ya sea a favor o en contra, de una intervención. En esta guía se utiliza el lenguaje “se recomienda” cuando se define una recomendación fuerte. Las recomendaciones débiles indican que los resultados para una intervención, favorable o desfavorable, son dudosos. En este caso, se utiliza el lenguaje “se sugiere”, cuando se define una recomendación débil. Cómo utilizar estas pautas: Las recomendaciones deben ser interpretadas en el contexto de la atención especializada, con estudios diagnósticos validados y realizados por médicos entrenados. Se asume que el médico tratante tiene alto nivel de sospecha de amiloidosis. No asume condiciones coexistentes que modifican el curso de la enfermedad. Asume que los estudios diagnósticos son realizados por médicos entrenados con métodos validados y estandarizados. Esta guía es relevante para los profesionales de la salud y los involucrados en las políticas sanitarias, para ayudar a asegurar que existan los acuerdos necesarios para brindar la atención adecuada. Resumen de recomendaciones En pacientes con sospecha de amiloidosis, se recomienda realizar: Un electrocardiograma como evaluación inicial a todo paciente con amiloidosis. Ecocardiograma Doppler convencional como imagen inicial de elección para el diagnóstico de amiloidosis cardíaca en pacientes con sospecha de compromiso cardíaco por amiloidosis. Ecocardiograma con deformación (strain) para el diagnóstico de amiloidosis cardíaca en pacientes con un ecocardiograma convencional sugestivo o indeterminado de amiloidosis. Resonancia magnética cardíaca (RMC) con gadolinio para el diagnóstico de amiloidosis cardíaca en pacientes con estudios previos sugestivos o indeterminados de amiloidosis. RMC con técnica de mapeo T1 para el diagnóstico de amiloidosis cardíaca en pacientes con estudios previos sugestivos de amiloidosis y disfunción renal o contraindicación para recibir gadolinio, como alternativa a la RMC con gadolinio. RMC con técnica de mapeo T1, medición de volumen extracelular y la cuantificación de la extensión del compromiso cardíaco para el diagnóstico y medición del compromiso cardíaco por amiloidosis en pacientes con estudios previos sugestivos de amiloidosis. Se sugiere realizar: RMC con técnica de mapeo T1 y medición del volumen extracelular para el diagnóstico precoz por amiloidosis en pacientes con estudios previos sugestivos de amiloidosis. Medición de péptido natriurético tipo B para el rastreo y diagnóstico de amiloidosis cardíaca. Centellograma con pirofosfato para el diagnóstico inicial de pacientes con sospecha de amiloidosis cardíaca, diferenciando ATTR (positiva) del resto. Method: Replace the various forms of PICO with specific testes. Giulio bus companies before 2019, Spain and Spain. The grade certificate recommended to your system (http://www.gradeworkinggroup.org/index.htm). As the recommended classification criteria, it is recommended to you (recommended or opposed) and recommended to you (recommended to you). As recommended by FINA, it is Ferramenta, which is composed of GLIA para barreiras e facilitadores em sua Implementação. Explicação sugerida: uma sugestão forte indica um alto nível de confiança no apoio ou oposição à intervenção. Ao definir recomendações fortes, este guia usa uma linguagem "recomendada". As recomendações mais fracas indicam que o resultado da intervenção (favorável ou desfavorável) é duvidoso. Nesse caso, se uma recomendação fraca for definida, a linguagem de "recomendação" será usada. Como usar essas diretrizes: As recomendações devem ser explicadas no contexto de cuidados especializados e estudos de diagnóstico validados realizados por médicos treinados. Não tem como premissa condições de coexistência que modificarão o curso da doença. Suponha que o médico assistente suspeite de um alto nível de amiloidose. Ele presumiu que a pesquisa diagnóstica foi conduzida por médicos bem treinados usando métodos padronizados validados. Este guia se aplica a profissionais de saúde e todos os envolvidos na política de saúde para ajudar a garantir que os arranjos necessários sejam feitos para fornecer cuidados adequados. Resumo das recomendações para diagnóstico Em pacientes com suspeita de amiloidose, é recomendado: Um eletrocardiograma como avaliação preliminar. Doppler convencional seja usado como primeira escolha para o diagnóstico de amiloidose cardíaca em pacientes com suspeita de amiloidose. Ecocardiografia deformada para o diagnóstico de pacientes com amiloidose ou ecocardiografia convencional incerta Ressonância magnética cardíaca (RMC) anterior seja usada para o diagnóstico de amiloidose cardíaca em pacientes que realizaram estudos sugestivos ou incertos sobre amiloidose. Mapeamento T1 para diagnosticar amiloidose cardíaca com RMC em pacientes com amiloidose e insuficiência renal ou contra-indicações de uso. Mapamento T1 para pacientes que estudaram previamente a amiloidose para medir o volume extracelular e quantificar o grau de envolvimento cardíaco para diagnosticar e medir o grau de envolvimento cardíaco em pacientes com amiloidose para exame de RMC. Sugere-se: Mapamento T1 e medição do volume extracelular para RMC para diagnosticar a amiloidose precocemente. Medir o peptídeo natriurético do tipo B para rastrear e diagnosticar a amiloidose cardíaca. Cintilografia com pirofosfato para fazer um diagnóstico preliminar de pacientes com suspeita de amiloidose cardíaca, de modo a distinguir ATTR (positivo) de outros pacientes. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-03-07 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html text/html text/html application/pdf application/pdf application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/30897 10.31053/1853.0605.v79.n1.30897 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. 1 (2022); 78-87 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. 1 (2022); 78-87 Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. 1 (2022); 78-87 1853-0605 0014-6722 10.31053/1853.0605.v79.n1 spa https://revistas.unc.edu.ar/index.php/med/article/view/30897/37120 https://revistas.unc.edu.ar/index.php/med/article/view/30897/37189 https://revistas.unc.edu.ar/index.php/med/article/view/30897/37190 https://revistas.unc.edu.ar/index.php/med/article/view/30897/37301 https://revistas.unc.edu.ar/index.php/med/article/view/30897/37300 https://revistas.unc.edu.ar/index.php/med/article/view/30897/37302 Derechos de autor 2022 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |