What is the clinical evidence from this study?

Study design: Review. Population: Hypertrophic cardiomyopathy and cardiac amyloidosis. Intervention: Multimodality cardiac imaging (Echocardiography, CMR, Nuclear imaging).

March 30, 2026SHILAP Revista de lepidopterologíaOpen Access

Cardiac imaging in hypertrophic cardiomyopathy and cardiac amyloidosis: a narrative review

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Key result

Multimodality cardiac imaging differentiates HCM from cardiac amyloidosis using distinct anatomical and tissue biomarkers.

Why the study?

Differentiating HCM from CA is clinically crucial because management strategies and prognostic implications differ substantially, yet overlapping phenotypic features such as left ventricular hypertrophy frequently complicate diagnosis.

Key Points

To review multimodality cardiac imaging approaches for differentiating hypertrophic cardiomyopathy from cardiac amyloidosis in patients presenting with unexplained myocardial thickening.
Synthesized diagnostic criteria and multimodality imaging features across echocardiography, cardiac MRI, SPECT, and PET based on clinical guidelines.
Evaluated morphological markers, Doppler flow velocities, strain dynamics, and tissue characterization metrics including late gadolinium enhancement and native T1/ECV mapping.
Hypertrophic cardiomyopathy typically displays asymmetric hypertrophy, dynamic left ventricular outflow tract obstruction in ~70% of cases, patchy mid-wall late gadolinium enhancement, and mildly elevated T1/ECV.
Cardiac amyloidosis is distinguished by concentric wall thickening (>12 mm), biatrial enlargement, apical sparing strain, diffuse subendocardial or transmural late gadolinium enhancement, and markedly elevated extracellular volume (>40%).
European Society of Cardiology criteria define adult hypertrophic cardiomyopathy by left ventricular wall thickness ≥15 mm, or 13–14 mm in the presence of family history, genetic mutations, or electrocardiographic abnormalities.

Structured PICO

Population

Patients with hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis (CA)

Intervention

Multimodality cardiac imaging (echocardiography, cardiac MRI, nuclear imaging)

This review highlights the critical role of multimodality imaging, including echocardiography and CMR, in differentiating hypertrophic cardiomyopathy from cardiac amyloidosis to guide appropriate management.

Limitations

Absolute cut-off values for quantitative imaging parameters should be applied with caution due to dependence on technical settings and post-processing methodologies.
Assessing mild-enhancement LGE is challenging because the signal intensity threshold is arbitrary.
The influence of myocardial disarray on T1 mapping in HCM remains debated and may lead to ECV overestimation.
ECV values in cardiac amyloidosis overlap with other cardiomyopathic pathologies such as acute myocardial infarction and dilated cardiomyopathy.

Discussion

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Implication

Enables targeted therapy for amyloidosis mimicking HCM; reinforces multimodality imaging value in ambiguous hypertrophy.

Cite This Study

Maggialetti et al. (2026) conducted a review in Hypertrophic cardiomyopathy and cardiac amyloidosis. Multimodality cardiac imaging (Echocardiography, CMR, Nuclear imaging) was evaluated. Multimodality cardiac imaging, including echocardiography, CMR, and nuclear imaging, provides distinct anatomical and tissue characterization biomarkers to differentiate HCM from cardiac amyloidosis.

synapsesocial.com/papers/69ca1210883daed6ee094e64 https://doi.org/10.3389/fcvm.2026.1752135

Topics

Hypertrophic cardiomyopathy Echocardiography Cardiac amyloidosis

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Cardiac imaging in hypertrophic cardiomyopathy and cardiac amyloidosis: a narrative review

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Cardiac imaging in hypertrophic cardiomyopathy and cardiac amyloidosis: a narrative review

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

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