The pulmonary valve (PV) is the least imaged among the heart valves. However, pulmonary regurgitation (PR) and pulmonary stenosis (PS) can occur in a variety of patients ranging from fetuses, newborns (e.g., tetralogy of Fallot) to adults (e.g., endocarditis, carcinoid syndrome, complications of operated tetralogy of Fallot). Due to their complexity, PR and PS are studied using multimodality imaging to assess their mechanism, severity, and hemodynamic consequences. Multimodality imaging is crucial to plan the correct management and to follow up patients with pulmonary valvulopathy. Echocardiography remains the first line methodology to assess patients with PR and PS, but the information obtained with this technique are often integrated with cardiac magnetic resonance (CMR) and computed tomography (CT). This state-of-the-art review aims to provide an updated overview of the usefulness, strengths, and limits of multimodality imaging in patients with PR and PS.

Mitral annular disjunction (MAD) was a frequent incidental finding at cardiac MRI examinations performed for various clinical indications; longer MAD length and coexisting bileaflet mitral valve prolapse were associated with a higher prevalence of arrhythmia.

Coronary artery disease is still a major cause of death and morbidity worldwide. In the setting of chronic coronary disease, demonstration of inducible ischemia is mandatory to address treatment. Consequently, scientific and technological efforts were made in response to the request for non-invasive diagnostic tools with better sensitivity and specificity. To date, clinicians have at their disposal a wide range of stress-imaging techniques. Among others, stress cardiac magnetic resonance (S-CMR) and computed tomography perfusion (CTP) techniques both demonstrated their diagnostic efficacy and prognostic value in clinical trials when compared to other non-invasive ischemia-assessing techniques and invasive fractional flow reserve measurement techniques. Standardized protocols for both S-CMR and CTP usually imply the administration of vasodilator agents to induce hyperemia and contrast agents to depict perfusion defects. However, both methods have their own limitations, meaning that optimizing their performance still requires a patient-tailored approach. This review focuses on the characteristics, drawbacks, and future perspectives of these two techniques.

Purpose of the Review: In this narrative review, we focus on the latest updates on CA–AS diagnosis, the implementation of CMR, and CT in the diagnostic algorithm and their future prospectives. Recent Findings: Aortic stenosis (AS) is the most common valvular heart disease (VHD) worldwide. In recent years, the association between Cardiac amyloidosis (CA) and AS has emerged as a not uncommon and sneaky association. Trans-thyretin (TTR) and immunoglobulin light chain (AL) are the two most common different types of misfolded amyloid proteins infiltrating the heart. AS–CA shares some anatomical features with CA, but the association leads to worse outcome. Nearly 30% of patients undergoing TAVR suffers from CA. Differentiating CA–AS from lone AS is of great importance to tailorize pharmaceutical therapy and/or surgery. Nowadays, bone scintigraphy and urine/serum analyses are crucial to assess which type of amyloid excess there is, but to represent anatomical changes of the myocardium cardiac magnetic resonance (CMR) and computed tomography cardiac angiography (CTCA), they are the best non-invasive tools. Moreover, extracellular expansion can be quantified via CMR, but new promising studies assessing extracellular volume (ECV) via CT are emerging. Furthermore, AS–CA is a sneaky pathology afflicting elderly patients. Seen the comorbidities of the typical patient, Transcatheter Aortic Valve Replacement (TAVR) should be the indicated procedure. CT is the best imaging modality for TAVR planning with its excellent anatomical resolution. Summary: CMR and CT could be integrated in the CA algorithm. Both can assess myocardium anatomical changes. Moreover, ECV is a precious tool to suggest the presence of amyloid in the myocardium.