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. 2021 Apr 7;42(16):1554–1568. doi: 10.1093/eurheartj/ehab072

Table 2.

Echocardiographic and cardiac magnetic resonance criteria for non-invasive and invasive (with extracardiac biopsy-proven amyloidosis) diagnosis of cardiac amyloidosis

Echocardiography
 Unexplained LV thickness (≥12 mm) plus 1 or 2:

  1. Characteristic echocardiography findings (≥ 2 of a, b, and c have to be present):

    1. Grade 2 or worse diastolic dysfunction

    2. Reduced tissue Doppler sʹ, eʹ, and aʹ waves velocities (<5 cm/s)

    3. Decreased global longitudinal LV strain (absolute value < −15%).

  2. Multiparametric echocardiographic score ≥8 points:

    1. Relative LV wall thickness (IVS+PWT)/LVEDD >0.6

      3 points

    2. Doppler E wave/eʹ wave velocities >11

      1 point

    3. TAPSE ≤ 19 mm

      2 points

    4. LV global longitudinal strain absolute value ≤ −13%

      1 point

    5. Systolic longitudinal strain apex to base ratio > 2.9

      3 points

CMR
 Characteristic CMR findings (a and b have to be present):

  1. Diffuse subendocardial or transmural LGE

  2. Abnormal gadolinium kineticsa

  3. ECV ≥0.40% (strongly supportive, but not essential/diagnostic)

CMR, cardiac magnetic resonance; ECV, extracellular volume; IVS, interventricular septum; LGE, late gadolinium enhancement; LV, left ventricular; LVEDD, left ventricular end-diastolic diameter; PWT, posterior wall thickness; TAPSE, tricuspid annular plane systolic excursion.

a

Abnormal gadolinium kinetics: myocardial nulling preceding or coinciding with the blood pool.