**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Natasha Gorrie, St Vincent's Hospital Sydney, Sydney, NSW

**Main Body of the Abstract**
Background:Light chain amyloidosis(AL) with advanced cardiomyopathy(CM) portends a prognosis of less than 6 months if untreated. The ANDROMEDA trial significantly improved outcomes but relies on diagnosis and accurate organ staging. Standard cardiac staging is limited by test sensitivity, particularly in early disease. Cardiac magnetic resonance(CMR) offers high resolution morphologic assessment and detailed tissue characterisation which is highly sensitive and specific for amyloidosis and holds promise for early diagnosis. CMR is not routine but recommended when echocardiography(TTE) is suggestive or other pathology suspected. We present a case series utilising CMR for early AL-CM diagnosis when other modalities were non-diagnostic.
Methods:All patients between 2022-2024 referred to St Vincent’s Amyloid multi-disciplinary team with suspected or confirmed AL who underwent CMR for clinical suspicion of cardiac disease were evaluated. Clinical suspicion was defined as unexplained symptoms(fatigue, breathlessness or oedema) or biomarker elevation, despite prior non-diagnostic cardiac imaging.
Results:Six clinically suspicious cases underwent CMR with all demonstrating AL-CM. All TTE's showed left ventricular(LV) ejection fraction and strain within normal parameters. TTE LV wall thickness was normal in four. Only two patients had suspicious symptoms but all had mildly elevated NT-proBNP. CMR in all demonstrated patchy late gadolinium enhancement without inflammation(normal T2) but increased extracellular volume(T1) and pericardial effusions. Diagnosis was confirmed via biopsy (3 endomyocardial, 1 pericardial, 1 renal, 1 bone-marrow). CMR altered diagnosis and treatment in three cases.
Conclusions:CMR holds promise in enhancing AL-CM diagnostic accuracy and early recognition, ultimately facilitating clinical decisions and improving care. Further studies of routine CMR use are required.



Cardiac Magnetic Resonance Imaging for the early diagnosis of AL cardiomyopathy: A case series PB128 (#445)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.