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Pica et al. Vessel Plus 2022;6:10 Vessel Plus
DOI: 10.20517/2574-1209.2021.81

Review Open Access

Disclosing the cardiomyopathic substrate within the

heart muscles in amyloidosis by cardiac magnetic
resonance: diagnostic and prognostic implications

Silvia Pica, Massimo Lombardi

Multimodality Cardiac Imaging, IRCCS Policlinico San Donato, San Donato Milanese, Milan 20097, Italy.
Correspondence to: Dr. Silvia Pica, Multimodality Cardiac Imaging, IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, San
Donato Milanese, Milan 20097, Italy. E-mail: silvia.pica@grupposandonato.it
How to cite this article: Pica S, Lombardi M. Disclosing the cardiomyopathic substrate within the heart muscles in amyloidosis
by cardiac magnetic resonance: diagnostic and prognostic implications. Vessel Plus 2022;6:10.
https://dx.doi.org/10.20517/2574-1209.2021.81

Received: 30 May 2021 First Decision: 1 Jul 2021 Revised: 19 Jul 2021 Accepted: 9 Aug 2021 Available online: 17 Feb 2022
Academic Editors: Gianfranco Sinagra, Ugolino Livi, Alexander D. Verin Copy Editor: Yue-Yue Zhang Production Editor: Yue-
Yue Zhang

Abstract
The use of cardiac magnetic resonance (CMR) for accurate morphological assessment of cardiomyopathies is well
described. CMR tissue characterization with late gadolinium enhancement and parametric mapping is highly
promising in differentiating key etiologies of left ventricular hypertrophy, diagnosing cardiac involvement in
systemic amyloidosis, detecting early disease, and tracking changes over time, as well as providing valuable
prognostic information. This review focuses on the typical imaging findings in cardiac amyloidosis by CMR,
highlighting its potentials with respect to traditional imaging techniques. Furthermore, the diagnostic and
prognostic role of CMR parameters and the future perspectives related to the newest applications are addressed.

Keywords: Amyloidosis, cardiac magnetic resonance, tissue characterization, mapping

INTRODUCTION
Amyloidosis is caused by aggregation and deposition of misfolded autologous proteins in the extracellular
space of several organs. Two types commonly infiltrate the heart: immunoglobulin light chain (AL) and
[1]
transthyretin (ATTR) amyloidosis. Cardiac involvement is the leading cause of morbidity and mortality ,
[2]
occurring in approximately 80% of AL, with a median survival of six months in untreated patients .

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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