Journal article
The role of cardiac imaging for diagnosis of cardiac amyloidosis: a systematic review and meta-analysis of test accuracy
Amyloid, Vol.33(1), pp.59-71
01/02/2026
DOI: 10.1080/13506129.2025.2596145
PMID: 41479129
Abstract
To evaluate the diagnostic test accuracy of cardiac magnetic resonance (CMR) and echocardiography for diagnosis of cardiac involvement in patients with biopsy proven light-chain (AL) amyloidosis.
This systematic review addresses late gadolinium enhancement (LGE) on CMR and different echocardiographic findings for cardiac involvement using an acceptable reference standard. Meta-analysis reported sensitivity and specificity with 95% confidence intervals when we have ≥3 studies, or ranges for 2 studies. We assessed certainty of evidence using GRADE (Grading of Recommendations Assessment, Development, and Evaluation).
Seven studies evaluated LGE, yielding pooled sensitivity and specificity of 0.95 (0.87-0.98) and 0.87 (0.76-0.94). Nineteen studies addressed echocardiography. Interventricular septum thickness showed sensitivity of 0.77 (0.69-0.84) and specificity of 0.71 (0.60-0.81). Diastolic dysfunction (grade 2-3) sensitivity was 0.71 (0.40-0.90) and specificity was 0.75 (0.64-0.84); restrictive filling pattern (grade 3) sensitivity was 0.42 (0.28-0.58) and specificity 0.89 (0.83-0.94). E/A ratio sensitivity ranged from 0.45 to 0.65, with specificity from 0.85 to 0.98. Global longitudinal strain sensitivity was 0.86 (0.65-0.95) and specificity was 0.76 (0.55-0.89). Apical sparing pattern showed sensitivity of 0.72 (0.64-0.78) and specificity of 0.78 (0.64-0.88). Certainty of evidence was very low.
CMR might be more accurate than echocardiography for diagnosis of cardiac involvement in AL amyloidosis.
Details
- Title: Subtitle
- The role of cardiac imaging for diagnosis of cardiac amyloidosis: a systematic review and meta-analysis of test accuracy
- Creators
- Hassan Kawtharany - University of Kansas Medical CenterMuayad Azzam - University of Kansas Medical CenterJamil Nazzal - University of Kansas Medical CenterQais Hamarsha - University of Kansas Medical CenterAseel Alkhader - University of Kansas Medical CenterTala Khraise - Northwestern Health Sciences UniversityMohammad M AlMasri - King Hussein Cancer CenterHadi K Abou Zeid - Mayo ClinicIktimal Alwan - AdventHealth TampaMhd Amin Alzabibi - University of Kansas Medical CenterNour Jaber - University of Kansas Medical CenterFaizi Jamal - City Of Hope National Medical CenterNoel Dasgupta - Indiana University School of MedicineNitasha Sarswat - Advanced Circulatory System (United States)Alfredo H De La Torre - Queen Elizabeth II Health Sciences CentreMaria Adela Aguirre - Hospital Italiano de Buenos AiresDeborah Boedicker - Universidade Presbiteriana MackenzieNaresh Bumma - The Ohio State UniversityAntonia S Carroll - St Vincent HospitalRaymond Comenzo - Tufts Medical CenterJoselle Cook - Mayo Clinic in ArizonaAngela Dispenzieri - Mayo Clinic in ArizonaJack Khouri - Cleveland ClinicMaria M Picken - Loyola University Medical CenterShahzad Raza - Cleveland ClinicNelson Leung - Mayo ClinicVaishali Sanchorawala - Boston Medical CenterHira Shaikh - University of IowaDaulath Singh - The Iowa Clinic PC, West Des Moines, IA, USAMatthew D Seftel - University of British ColumbiaVishal Kukreti - Princess Margaret Cancer CentreReem A Mustafa - University of Kansas Medical Center
- Resource Type
- Journal article
- Publication Details
- Amyloid, Vol.33(1), pp.59-71
- DOI
- 10.1080/13506129.2025.2596145
- PMID
- 41479129
- NLM abbreviation
- Amyloid
- ISSN
- 1744-2818
- eISSN
- 1744-2818
- Publisher
- Taylor & Francis; ABINGDON
- Grant note
- American Society of Hematology
This work was funded by the American Society of Hematology as part of clinical practice guidelines on the diagnosis of light-chain amyloidosis.
- Language
- English
- Electronic publication date
- 01/01/2026
- Date published
- 01/02/2026
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985113251802771
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