An echocardiography-derived AMYLI score demonstrated a significant association with myocardial amyloid burden and long-term mortality risk in patients with cardiac amyloidosis. These findings were reported in a single-center, prospective observational study presented at the American Heart Association (AHA) 2025 Scientific Sessions.

The study enrolled 307 newly diagnosed, biopsy-proven immunoglobulin light-chain (AL) amyloidosis patients who underwent both transthoracic echocardiography and cardiac magnetic resonance imaging (CMR). The AMYLI score was calculated as the product of relative wall thickness (RWT) and E/e′. Cardiac amyloid burden was quantified using CMR-derived parameters, including late gadolinium enhancement and extracellular volume (ECV).

The AMYLI score showed a moderate positive correlation with ECV (r = 0.57; P < 0.001). During a median follow-up of 42 months (interquartile range, 35-49 months), 173 patients died. An AMYLI score ≥7.85 was associated with a significantly higher risk of all-cause mortality (hazard ratio [HR] 2.80; 95% confidence interval [CI], 1.80-4.35; P < 0.001).

After adjustment for clinical, biochemical, echocardiographic, CMR-related, and therapeutic variables, an AMYLI score ≥7.85 remained an independent predictor of mortality across all models. The score also provided incremental prognostic value beyond conventional clinical and imaging risk factors.

These findings indicate that the AMYLI score functions as a reliable echocardiography-based marker of amyloid burden and an independent prognostic indicator in cardiac amyloidosis, supporting its role in risk stratification.