A thousand words about the imaging in cardiac amyloidosis





amyloidosis, echocardiography, myocardial strain imaging, cardiac magnetic resonance


Cardiac amyloidosis is an infiltrative disease which usually occurs under the form of restrictive cardiomyopathy. Advances in the treatment have changed the unfavorable outcomes of this disease. Thus, early diagnosis is essential. Recent advances in echocardiography and cardiac magnetic resonance provided new modalities for the detection of cardiac amyloidosis. This summary discusses the role of imaging techniques in the diagnosis of cardiac amyloidosis.


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Maleszewski JJ. Cardiac amyloidosis: pathology, nomenclature, and typing. Cardiovasc Pathol. 2015;24(6):343–50.

Benson MD, Buxbaum JN, Eisenberg DS, Merlini G, Saraiva MJM, Sekijima Y, et al. Amyloid nomenclature 2018: recommendations by the International Society of Amyloidosis (ISA) nomenclature committee. Amyloid. 2018;25(4):215–9.

Sipe JD, Benson MD, Buxbaum JN, Ikeda S‑i, Merlini G, Saraiva MJM, et al. Nomenclature 2014: Amyloid fibril proteins and clinical classification of the amyloidosis. Amyloid. 2014;21(4):221–4.

Jacobson DR, Pastore RD, Yaghoubian R, Kane I, Gallo G, Buck FS, et al. Variant‑sequence transthyretin (isoleucine 122) in late‑onset cardiac amyloidosis in black Americans. N Engl J Med. 1997;336(7):466–73.

Rapezzi C, Quarta CC, Obici L, Perfetto F, Longhi S, Salvi F, et al. Disease profile and differential diagnosis of hereditary transthyretin‑related amyloidosis with exclusively cardiac phenotype: an Italian perspective. Eur Heart J. 2013;34(7):520–8.

Pinney JH, Smith CJ, Taube JB, Lachmann HJ, Venner CP, Gibbs SD, et al. Systemic amyloidosis in England: an epidemiological study. Br J Haematol. 2013;161(4):525–32.

González‑López E, Dominguez F, Alonso‑Pulpon L, Cobo‑Marcos M, Garcia‑Pavia P, Lara‑Pezzi E, et al. Clinical characteristics of wild‑type transthyretin cardiac amyloidosis: disproving myths. European Heart Journal. 2017;38(24):1895–904.

Mohammed SF, Mirzoyev SA, Edwards WD, Dogan A, Grogan DR, Dunlay SM, et al. Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction. JACC Heart Fail. 2014;2(2):113–22.

Castano A, Narotsky DL, Hamid N, Khalique OK, Morgenstern R, DeLuca A, et al. Unveiling transthyretin cardiac amyloidosis and its predictors among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Eur Heart J. 2017;38(38):2879–87.

Morner S, Hellman U, Suhr OB, Kazzam E, Waldenstrom A. Amyloid heart disease mimicking hypertrophic cardiomyopathy. J Intern Med. 2005;258(3):225–30.

Falk RH. Tafamidis for transthyretin amyloid cardiomyopathy: the solution or just the beginning of the end? European Heart Journal. 2019;40(12):1009–12.

Picano E, Pinamonti B, Ferdeghini E, Landini L, Slavich G, Orlandini A, et al. Two‑Dimensional Echocardiography in Myocardial Amyloidosis. Echocardiography. 1991;8(2):253–9.

Cacciapuoti F. The role of echocardiography in the non‑invasive diagnosis of cardiac amyloidosis. J Echocardiogr. 2015;13(3):84–9.

Di Nunzio D, Recupero A, de Gregorio C, Zito C, Carerj S, Di Bella G. Echocardiographic Findings in Cardiac Amyloidosis: Inside Two‑Dimensional, Doppler, and Strain Imaging. Curr Cardiol Rep. 2019;21(2):7.

Lang RM, Badano LP, Mor‑avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. 2015;28(1):1–39.e14.

Bellavia D, Abraham TP, Pellikka PA, Al‑Zahrani GB, Dispenzieri A, Oh JK, et al. Detection of left ventricular systolic dysfunction in cardiac amyloidosis with strain rate echocardiography. J Am Soc Echocardiogr. 2007;20(10):1194–202.

Phelan D, Collier P, Thavendiranathan P, Popovic ZB, Hanna M, Plana JC, et al. Relative apical sparing of longitudinal strain using two‑dimensional speckle‑tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis. Heart. 2012;98(19):1442–8.

Marwick TH, Shah SJ, Thomas JD. Myocardial Strain in the Assessment of Patients With Heart Failure: A Review. JAMA Cardiol. 2019.

Sun JP, Stewart WJ, Yang XS, Donnell RO, Leon AR, Felner JM, et al. Differentiation of hypertrophic cardiomyopathy and cardiac amyloidosis from other causes of ventricular wall thickening by two‑dimensional strain imaging echocardiography. Am J Cardiol. 2009;103(3):411–5.

Pagourelias ED, Duchenne J, Mirea O, Vovas G, Van Cleemput J, Delforge M, et al. The Relation of Ejection Fraction and Global Longitudinal Strain in Amyloidosis: Implications for Differential Diagnosis. JACC: Cardiovascular Imaging. 2016;9(11):1358–9.

Maceira AM, Joshi J, Prasad SK, Moon JC, Perugini E, Harding I, et al. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation. 2005;111(2):186–93.

Syed IS, Glockner JF, Feng D, Araoz PA, Martinez MW, Edwards WD, et al. Role of Cardiac Magnetic Resonance Imaging in the Detection of Cardiac Amyloidosis. JACC: Cardiovascular Imaging. 2010;3(2):155–64.

Fontana M, Banypersad SM, Treibel TA, Maestrini V, Sado DM, White SK, et al. Native T1 mapping in transthyretin amyloidosis. JACC Cardiovasc Imaging. 2014;7(2):157–65.

Dungu JN, Valencia O, Pinney JH, Gibbs SD, Rowczenio D, Gilbertson JA, et al. CMR‑based differentiation of AL and ATTR cardiac amyloidosis. JACC Cardiovasc Imaging. 2014;7(2):133–42.


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Dankowski R, Leszniewski M, Pyda M, Szyszka A. A thousand words about the imaging in cardiac amyloidosis. JMS [Internet]. 2019 Apr. 3 [cited 2024 Jul. 19];88(2):123-8. Available from: https://jms.ump.edu.pl/index.php/JMS/article/view/350
Received 2019-03-24
Accepted 2019-03-30
Published 2019-04-03