Echocardiography plays a crucial role in raising the suspicion of cardiac amyloidosis in patients with increased left ventricular wall thickness, though confirmatory tests are required for diagnosis.
The British Society of Echocardiography provides an updated guideline and minimum dataset for the echocardiographic evaluation of cardiac amyloidosis, highlighting the critical role of strain imaging.
These guidelines form an update of the BSE guideline protocol for the assessment of restrictive cardiomyopathy (Knight et al. in Echo Res Prac, 2013). Since the original recommendations were conceived in 2013, there has been an exponential rise in the diagnosis of cardiac amyloidosis fuelled by increased clinician awareness, improvements in cardiovascular imaging as well as the availability of new and effective disease modifying therapies. The initial diagnosis of cardiac amyloidosis can be challenging and is often not clear-cut on the basis of echocardiography, which for most patients presenting with heart failure symptoms remains the first-line imaging test. The role of a specialist echocardiographer will be to raise the suspicion of cardiac amyloidosis when appropriate, but the formal diagnosis of amyloid sub-type invariably requires further downstream testing. This document seeks to provide a focused review of the literature on echocardiography in cardiac amyloidosis highlighting its important role in the diagnosis, prognosis and screening of at risk individuals, before concluding with a suggested minimum data set, for use as an aide memoire when reporting.
Moody et al. (2023) conducted a review in Cardiac amyloidosis. Transthoracic echocardiography was evaluated. Echocardiography plays a crucial role in raising the suspicion of cardiac amyloidosis in patients with increased left ventricular wall thickness, though confirmatory tests are required for diagnosis.