Amyloid transthyretin (ATTR) amyloidosis is a protein-misfolding disease characterized by fibril accumulation in the extracellular space that can result in local tissue disruption and organ dysfunction. Cardiac involvement drives morbidity and mortality, and the heart is the major organ affected by ATTR amyloidosis. Multimodality cardiac imaging (ie, echocardiography, scintigraphy, and cardiac magnetic resonance) allows accurate diagnosis of ATTR cardiomyopathy (ATTR-CM), and this is of particular importance because ATTR-targeting therapies have become available and probably exert their greatest benefit at earlier disease stages. Apart from establishing the diagnosis, multimodality cardiac imaging may help to better understand pathogenesis, predict prognosis, and monitor treatment response. The aim of this review is to give an update on contemporary and evolving cardiac imaging methods and their role in diagnosing and managing ATTR-CM. Further, an outlook is presented on how artificial intelligence in cardiac imaging may improve future clinical decision making and patient management in the setting of ATTR-CM.

淀粉样转甲状腺素蛋白 (ATTR) 淀粉样变性是一种蛋白质错误折叠疾病，其特征是细胞外空间中原纤维积聚，可导致局部组织破坏和器官功能障碍。心脏受累会导致发病率和死亡率，心脏是 ATTR 淀粉样变性影响的主要器官。多模态心脏成像（即超声心动图、闪烁扫描和心脏磁共振）可以准确诊断 ATTR 心肌病 (ATTR-CM)，这一点特别重要，因为 ATTR 靶向疗法已经可用，并且可能在早期疾病中发挥最大益处阶段。除了确定诊断外，多模态心脏成像还可能有助于更好地了解发病机制、预测预后和监测治疗反应。本综述的目的是提供当代和不断发展的心脏成像方法及其在诊断和管理 ATTR-CM 中的作用的最新信息。此外，还展望了心脏成像中的人工智能如何在 ATTR-CM 的背景下改善未来的临床决策和患者管理。