IJCS | Volume 32, Nº2, March/April 2019

187 1. Bulluck H, White SK, Rosmini S, Bhuva A, Treibel TA, Fontana M, et al. T1 mapping and T2 mapping at 3T for quantifying the area-at-risk in reperfused STEMI patients. J CardiovascMagn Reson. 2015 Aug 12;17:73. 2. Meier-Ewert HK, Sanchorawala V, Berk JL, Ruberg FL. Cardiac amyloidosis: evolving approach to diagnosis and management. Curr Treat Options Cardiovasc Med. 2011;13(6):528-42. 3. Ritts AJ, Cornell RF, Swiger K, Singh J, Goodman S, Lenihan DJ. Current Concepts of Cardiac Amyloidosis: Diagnosis, Clinical Management, and the Need for Collaboration. Heart Fail Clin. 2017;13(2):409-16. 4. Sara L, Szarf G, Tachibana A, Shiozaki AA, Villa AV, de Oliveira AC, et al., Sociedade Brasileira de Cardiologia and Colegio Brasileiro de Radiologia. [II Guidelines on Cardiovascular Magnetic Resonance and Computed Tomography of the Brazilian Society of Cardiology and the Brazilian College of Radiology]. Arq Bras Cardiol. 2014;103(6 Suppl 3):1-86. 5. Fontana M. Prognosis in cardiac amyloidosis by LGE: ready for prime time? JACC Cardiovasc Imaging. 2016;9(6):687-9. 6. Fontana M, Martinez-Naharro A, Hawkins PN. Staging cardiac amyloidosis with CMR: understanding the different phenotypes. JACC Cardiovasc Imaging. 2016;9(11):1278-9. 7. FontanaM,PicaS,ReantP,Abdel-GadirA,TreibelTA,BanypersadSM,etal. Prognostic value of late gadoliniumenhancement cardiovascularmagnetic resonance in cardiac amyloidosis. Circulation. 2015;132(16):1570-9. 8. Fontana M, Pica S, Reant P, Abdel-Gadir A, Treibel TA, Banypersad SM, et al. Response to letters regarding article, "Prognostic value of late gadolinium enhancement cardiovascular magnetic resonance in cardiac amyloidosis". Circulation. 2016;133(12):e450-1. 9. Falk RH, Dubrey SW. Amyloid heart disease. Prog Cardiovasc Dis. 2010;52(4):347-61. Erratum in: Prog Cardiovasc Dis. 2010;52(5):445-7. 10. Sher T, Gertz MA. Recent advances in the diagnosis and management of cardiac amyloidosis. Future Cardiol. 2014;10(1):131-46. 11. Maceira AM, Prasad SK, Hawkins PN, Roughton M, Pennell DJ. Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis. J Cardiovasc Magn Reson. 2008 Nov 25;10:54. 12. Maurer MS, Elliott P, Comenzo R, Semigran M, Rapezzi C. Addressing Common Questions Encountered in the Diagnosis and Management of Cardiac Amyloidosis. Circulation. 2017;135(14):1357-77. 13. Perfetto F, Cappelli F, Bergesio F, Ciuti G, Porciani MC, Padeletti L, et al. Cardiac amyloidosis: the heart of the matter. Intern Emerg Med. 2013;8(3):191-203. References Ribeiro et al. CMR and amyloidosis Int J Cardiovasc Sci. 2019;32(2)177-189 Review Article that tafamidis was associated with reductions in all- cause mortality, cardiovascular-related hospitalizations and the decline in functional capacity and quality of life as compared with placebo, in patients with exclusively transthyretin amyloid cardiomyopathy. 63 This will soon extend the range of indications of the use of tafamidis in hereditary amyloidosis, previously restricted only to patients with polyneuropathy. Although amyloid deposits are very stable, the body has limited capacity to eliminate them, particularly from myocardial deposits. The concept of passive immunotherapy to increase amyloid deposit clearance has been proven effective in experimental models and has been widely developed. 17 Experimental studies have shown that doxycycline, a widely used antimicrobial agent, affects the synthesis of amyloid fibrils, and when combined with biliary salts (taurodeoxycholic acid), shows a synergic effect in removing transthyretin deposits from tissues; these findings have led to studies in humans. In addition, the presence of a flavonoid abundant in green tea, has motivated studies on cardiac amyloidosis, since it has been demonstrated that this compound can inhibit amyloid fibril formation. 12 Cardiac transplantation has yielded disappointing results because of themultisystemic nature of amyloidosis; nevertheless, in highly selective cases undergoing suppression of light chain, and after treatment of extracardiac disease, prognosis may be good. 17,58 Conclusion CMR can evaluate amyloid deposits in cardiac tissues by delayed enhancement technique, even when cardiac function is preserved. CMR is rewriting the knowledge about cardiac amyloidosis, leading to the development of new classification models and therapies as well as change in the prognosis of the patients. Potential Conflict of Interest There is no potential conflict of interest to declare. Sources of funding There was no external funding for the study. Study association This report is part of the “scientific initiation” research project of Vaneza Ferreira Ribeiro at the Department of Radiology of Fluminense Federal University Medical School, Niterói-RJ, Brazil. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors.