Perspective:

Cardiac MRI appears to be prognostically useful in patients with AL amyloidosis. This adds to a growing body of literature that has demonstrated the value of MRI techniques in amyloidosis. This study specifically demonstrates that global LGE has particular prognostic importance beyond traditional biomarker staging of cardiac involvement in amyloidosis. As a retrospective, observational study, several caveats must be noted. First, it is likely that there is some degree of referral bias, as patients with low likelihood of cardiac involvement based on clinical history and symptoms may have been less likely to be referred. Second, nearly one half of all potential patients were excluded, potentially limiting generalizability. Nonetheless, this important result demonstrates the potential clinical application of this technique.