British Society of Echocardiography guideline for the transthoracic echocardiographic assessment of cardiac amyloidosis

Table 1 Relative utility of echo parameters for diagnosis and prognosis in cardiac amyloidosis

Echo parameter*	ATTR-CM		AL-CM
	Diagnosis	Prognosis	Diagnosis	Prognosis
LV wall thickening	+ +	+	+	+
RV wall thickening	+ +	+	+ +	+
Pericardial effusion	+	+	+ +	+ +
Apical sparing GLS pattern	+ + +	NA	+ + +	NA
Reduced GLS	+	+ + +	+	+ + +
Elevated E/e′	+ +	+ +	+ +	+ +
Bi-atrial dilatation	+ +	+ +	+ +	+ +
Low-flow low-gradient severe AS	+ +	+	NA	NA
RV systolic dysfunction (FAC, RV s′)	NA	+ + +	NA	+ + +
Mitral regurgitation (Carpentier Type 1 / 3a)	+ +	+ + +	+	+ +
Tricuspid regurgitation (Carpentier Type 1 / 3a)	+ +	+ + +	+	+ +
EFSR**	+ + +	NA	+ + +	NA
MCF ratio**	+ + +	+	+ + +	+

AL-CM light chain amyloid cardiomyopathy, ATTR-CM transthyretin amyloid cardiomyopathy, EFSR left ventricular ejection fraction to global longitudinal strain ratio, FAC fractional area change, GLS global longitudinal strain, LV left ventricular, MCF myocardial contraction fraction ratio, NA not applicable, RV right ventricular
^*The diagnostic specificity of all echo parameters is reduced in the context of uraemic or hypertensive cardiomyopathy
^**These echo parameters provide diagnostic utility in cardiac amyloidosis but are not included in the BSE minimum dataset

ISSN: 2055-0464