Artificial Intelligence in Cardiac Amyloidosis: A State-of-the-Art Review

Cardiac amyloidosis (CA) remains underrecognized due to overlapping features with other cardiovascular conditions, including hypertrophic cardiomyopathy and hypertensive heart disease. Certain 'red flag' features across the clinical and imaging spectrum help identify CA. However, these features are often absent, subtle, or inconsistently recognized, particularly in early disease, and are atypical phenotypes. This leads to frequent delays in diagnosis and presentation at advanced stages. Artificial intelligence (AI) offers a promising approach to detect subtle disease signatures by integrating multimodal and longitudinal data beyond human pattern recognition. AI-enhanced electrocardiography has emerged as a scalable screening tool, demonstrating high diagnostic performance and enabling earlier detection. In parallel, echocardiographic AI has evolved toward video-based analysis, improving standardization and reducing inter-reader variability. Similarly, AI applications in cardiac magnetic resonance and nuclear scintigraphy allow for automated quantification and more reproducible assessment of amyloid burden. Beyond diagnosis, emerging models support disease phenotyping, risk stratification, and treatment monitoring. This review synthesizes current applications of AI across multimodal testing in the evaluation and diagnosis of CA.