Longitudinal strain imaging in light-chain cardiac amyloidosis: can it help to refine the approach to treatment?

The systemic amyloidoses are a group of uncommon diseases characterized by extracellular accumulation of fibrillar proteins, leading to loss of normal tissue architecture and function (1). Light-chain (AL) amyloidosis, which is probably the most frequent form, can potentially involve any organ, but when the heart is affected, the outcome is particularly poor, with a median survival of 4 to 6 months (2). Over the past few years, the chemotherapeutic options for treating AL amyloidosis have expanded considerably, but the more aggressive therapies, such as high-dose melphalan with autologous stem cell transplantation, are limited in many patients with cardiac involvement (3,4).