Cardiovascular magnetic resonance for suspected cardiac amyloidosis: where are we now?

Heart Fail Rev. 2022 Sep;27(5):1543-1548. doi: 10.1007/s10741-022-10226-w. Epub 2022 Mar 4.


Cardiac amyloidosis (CA) is an underdiagnosed form of restrictive cardiomyopathy leading to a rapid progression into heart failure. Evaluation of CA requires a multimodality approach making use of echocardiography, cardiac magnetic imaging (CMR), and nuclear imaging. With superior tissue characterization, high-resolution imaging, and precise cardiac assessment, CMR has emerged as a versatile tool in the workup of cardiac amyloidosis with a wide array of parameters both visual and quantitative. This includes late gadolinium enhancement patterns, T1/T2 mapping, and extracellular volume (ECV) measurement providing robust diagnostic accuracies, patient stratification, and prognostication. Recent advancements have introduced new measures able to identify early disease, track disease progression, and response to therapy positioning CMR as an instrumental imaging modality in the era of rising interest in CA screening and emerging effective therapies.

Keywords: CMR; Cardiac amyloidosis; ECV; LGE; T1 mapping; T2 mapping.

Publication types

  • Review

MeSH terms

  • Amyloidosis* / diagnostic imaging
  • Amyloidosis* / pathology
  • Cardiomyopathies* / diagnostic imaging
  • Cardiomyopathies* / pathology
  • Contrast Media
  • Gadolinium
  • Humans
  • Magnetic Resonance Imaging
  • Magnetic Resonance Imaging, Cine
  • Magnetic Resonance Spectroscopy
  • Myocardium / pathology
  • Predictive Value of Tests


  • Contrast Media
  • Gadolinium