The Last Decade in Cardiac Amyloidosis

Cardiac amyloidosis represents a unique disease process characterized by amyloid fibril deposition within the myocardial
extracellular space. Advances in multimodality cardiac imaging enable accurate diagnosis and facilitate prompt initiation
of disease-modifying therapies. Furthermore, rapid advances in multimodality imaging have enriched understanding of
the underlying pathogenesis, enhanced prognostication, and resulted in the development of imaging-based markers that
reflect the amyloid burden, which is of increasing importance when assessing the response to treatment. Whereas
conventional therapies have focused on reducing amyloid formation and subsequent stabilization of the cardiac disease
process, novel agents are being developed to accelerate the immune-mediated removal of amyloid fibrils from the heart.
In this context, the ability to track changes in the amyloid burden over time is of paramount importance. Although
advanced imaging techniques have shown efficacy in tracking the treatment response, future research focused on
improved precision through use of artificial intelligence may augment the detection of changes earlier in the course of
treatment. (JACC Cardiovasc Imaging. 2025;18:478–499) © 2025 The Authors. Published by Elsevier on behalf of
the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).