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AFD involves renal, cardiac, vascular, and nervous systems and is mainly observed in male patients with onset in childhood, although cardiac manifestation is often shown in adults. AFD cardiomyopathy is caused by the accumulation of Gb3 within myocytes first showed by left ventricular hypertrophy and diastolic dysfunction, leading to restrictive cardiomyopathy and systolic heart failure with biventricular involvement. The diagnosis of AFD cardiomyopathy may be insidious in the first stages and requires accurate differential diagnosis with other cardiomyopathies with hypertrophic phenotype. However, it is fundamental to promptly initiate specific therapies that have shown promising results, particularly for early treatment. A careful integration between clinical evaluation, genetic tests, and cardiac imaging is required to diagnose AFD with cardiac involvement. Basic and advanced echocardiography, cardiac magnetic resonance, and nuclear imaging may offer pivotal information for early diagnosis (Graphical Abstract), and the management of these patients is often limited to centres with high expertise in the field. This clinical consensus statement, developed by experts from the European Society of Cardiology (ESC) Working Group on Myocardial and Pericardial Diseases and the European Association of Cardiovascular Imaging of the ESC, aims to provide practical advice for all clinicians regarding the use of multimodality imaging to simplify the diagnostic evaluation, prognostic stratification, and management of cardiac involvement in AFD.<\/jats:p>","DOI":"10.1093\/ehjci\/jeaf038","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T23:15:03Z","timestamp":1738451703000},"page":"814-829","source":"Crossref","is-referenced-by-count":18,"title":["The role of cardiovascular multimodality imaging in the evaluation of Anderson\u2013Fabry disease: from early diagnosis to therapy monitoring"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-8964","authenticated-orcid":false,"given":"Matteo","family":"Cameli","sequence":"first","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , viale Bracci 16, 53100 Siena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Pieroni","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, University of Florence, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concetta","family":"Pastore","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnologies, Division of Cardiology, University of Siena , viale Bracci 16, 53100 Siena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-5600","authenticated-orcid":false,"given":"Antonio","family":"Brucato","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9693-4083","authenticated-orcid":false,"given":"Silvia","family":"Castelletti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IRCCS, Istituto Auxologico Italiano, San Luca Hospital, Cardiomyopathy Unit , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Crotti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IRCCS, Istituto Auxologico Italiano, San Luca Hospital, Cardiomyopathy Unit , Milan ,","place":["Italy"]},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Dweck","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh , Edinburgh ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5748-0725","authenticated-orcid":false,"given":"Andrea","family":"Frustaci","sequence":"additional","affiliation":[{"name":"IRCCS L.Spallanzani , Via Portuense 292, 00149Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Gimelli","sequence":"additional","affiliation":[{"name":"Department of Cardiac Imaging, Fondazione Toscana G. 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