Key result
CMR extracellular volume fraction accurately identifies cardiac amyloidosis in elderly HF patients with an AUC of ~0.90.
Why the study?
The diagnostic accuracy of cardiac magnetic resonance T1 mapping for cardiac amyloidosis in elderly patients with heart failure was not well established.
Does cardiac magnetic resonance T1 mapping and extracellular volume fraction accurately diagnose cardiac amyloidosis in elderly patients with heart failure?
Observational (n=112)
No
Does cardiac magnetic resonance T1 mapping and extracellular volume fraction accurately diagnose cardiac amyloidosis in elderly patients with heart failure?
Effect estimate: AUC 0.904 (95% CI 0.825-0.982)
CMR with native T1 mapping and ECV measurement provides high diagnostic accuracy for identifying or excluding cardiac amyloidosis in elderly patients with heart failure and preserved or mildly reduced ejection fraction.
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Supports ECV for noninvasive cardiac amyloidosis detection in elderly HF; leaves open prospective validation before practice change.
Unger et al. (2026) conducted an observational in Heart failure with suspected cardiac amyloidosis (n=112). Cardiac magnetic resonance (CMR) T1 mapping and extracellular volume fraction (ECV) vs. Bone scintigraphy and monoclonal protein screening (reference standard) was evaluated on Diagnostic accuracy of T1 imaging and extracellular volume fraction (ECV) for the diagnosis of cardiac amyloidosis (AUC 0.904, 95% CI 0.825-0.982). Cardiac magnetic resonance extracellular volume fraction (ECV) demonstrated high diagnostic accuracy for identifying cardiac amyloidosis in elderly patients with heart failure, yielding an AUC of 0.904.
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