CMR in the Age of Amyloid Therapeutics-CMR in the Age of Amyloid Therapeutics

Video Transcription

Video Summary

The webinar “SCMR in the Age of Amyloid Therapeutics” focused on how cardiac magnetic resonance (CMR) supports diagnosis, phenotyping, prognosis, and treatment monitoring in cardiac amyloidosis. Moderators Dr. Purvi Parwani and Dr. Vinita Ojha introduced the session as a fast-moving, four-talk educational program.<br /><br />Dr. Sara Khadi opened with an overview of amyloidosis subtypes, emphasizing ATTR and AL as the main causes of cardiac disease. She reviewed clinical red flags, echo findings, and the role of CMR in detecting early disease through late gadolinium enhancement (LGE) and extracellular volume (ECV) mapping. She stressed that CMR is especially useful when suspicion remains high despite negative or equivocal blood tests or scintigraphy, and it helps guide biopsy decisions and prognosis.<br /><br />Dr. William Moody then discussed technical aspects of CMR, especially nulling, phase-sensitive inversion recovery (PSIR), and the importance of ECV over native T1 for reproducibility and disease tracking. He also highlighted practical issues such as contrast choice, renal safety, and the limitations of trying to distinguish AL from ATTR based on CMR alone.<br /><br />Professor James Moon explained how quantitative biomarkers can identify disease earlier and monitor progression or regression. He emphasized that ECV is the most direct and robust marker of myocardial amyloid burden, while T2 may reflect more aggressive or inflammatory disease, often seen in AL.<br /><br />Finally, Dr. Michael Salerno presented real-world cases showing how CMR can uncover amyloidosis even when echo or ECG are misleading, and can also help differentiate mimics such as Fabry disease or hypertrophic cardiomyopathy.<br /><br />The session concluded with a lively Q&A on mapping strategy, extracardiac ECV, and technical pitfalls in amyloid imaging.

Keywords

cardiac magnetic resonance

CMR

amyloidosis

ATTR amyloidosis

AL amyloidosis

late gadolinium enhancement

extracellular volume

ECV mapping

myocardial imaging

PSIR

Fabry disease