Skip to main content
main-content

01.12.2018 | Research | Ausgabe 1/2018 Open Access

Journal of Cardiovascular Magnetic Resonance 1/2018

The prognostic value of T1 mapping and late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with light chain amyloidosis

Zeitschrift:
Journal of Cardiovascular Magnetic Resonance > Ausgabe 1/2018
Autoren:
Lu Lin, Xiao Li, Jun Feng, Kai-ni Shen, Zhuang Tian, Jian Sun, Yue-ying Mao, Jian Cao, Zheng-yu Jin, Jian Li, Joseph B. Selvanayagam, Yi-ning Wang

Abstract

Background

Cardiac impairment is associated with high morbidity and mortality in immunoglobulin light chain (AL) type amyloidosis, for which early identification and risk stratification is vital. For myocardial tissue characterization, late gadolinium enhancement (LGE) is a classic and most commonly performed cardiovascular magnetic resonance (CMR) parameter. T1 mapping with native T1 and extracellular volume (ECV) are recently developed quantitative parameters. We aimed to investigate the prognostic value of native T1, ECV and LGE in patients with AL amyloidosis.

Methods

Eighty-two patients (55.5 ± 8.5 years; 52 M) and 20 healthy subjects (53.2 ± 11.7 years; 10 M) were prospectively recruited. All subjects underwent CMR with LGE imaging and T1 mapping using a Modified Look-Locker Inversion-recovery (MOLLI) sequence on a 3 T scanner. Native T1 and ECV were measured semi-automatically using a dedicated CMR software. The left ventricular (LV) LGE pattern was classified as none, patchy, and global groups. Global LGE was considered when there was diffuse, transmural LGE in more than half of the short axis images. Follow-up was performed for all-cause mortality using Cox proportional hazards regression analysis and Kaplan-Meier survival curves.

Results

The patients demonstrated an increase in native T1 (1438 ± 120 ms vs. 1283 ± 46 ms, P = 0.001) and ECV (43.9 ± 10.9% vs. 27.0 ± 1.7%, P = 0.001) compared to healthy controls. Native T1, ECV and LGE showed significant correlation with Mayo Stage, and ECV and LGE showed significant correlation with echocardiographic E/E’ and LV ejection fraction. During the follow-up for a median time of 8 months, 21 deaths occurred. ECV ≥ 44.0% (hazard ratio [HR] 7.249, 95% confidence interval (CI) 1.751–13.179, P = 0.002) and global LGE (HR 4.804, 95% CI 1.971–12.926, P = 0.001) were independently prognostic for mortality over other clinical and imaging parameters. In subgroups with the same LGE pattern, ECV ≥ 44.0% remained prognostic (log rank P = 0.029). Median native T1 (1456 ms) was not prognostic for mortality (Tarone-Ware, P = 0.069).

Conclusions

During a short-term follow-up, both ECV and LGE are independently prognostic for mortality in AL amyloidosis. In patients with a similar LGE pattern, ECV remained prognostic. Native T1 was not found to be a prognostic factor.
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2018

Journal of Cardiovascular Magnetic Resonance 1/2018 Zur Ausgabe

Neu im Fachgebiet Radiologie

Meistgelesene Bücher aus der Radiologie

2016 | Buch

Medizinische Fremdkörper in der Bildgebung

Thorax, Abdomen, Gefäße und Kinder

Dieses einzigartige Buch enthält ca. 1.600 hochwertige radiologische Abbildungen und Fotos iatrogen eingebrachter Fremdmaterialien im Röntgenbild und CT.

Herausgeber:
Dr. med. Daniela Kildal

2011 | Buch

Atlas Klinische Neuroradiologie des Gehirns

Radiologie lebt von Bildern! Der vorliegende Atlas trägt dieser Tatsache Rechnung. Sie finden zu jedem Krankheitsbild des Gehirns Referenzbilder zum Abgleichen mit eigenen Befunden.

Autoren:
Priv.-Doz. Dr. med. Jennifer Linn, Prof. Dr. med. Martin Wiesmann, Prof. Dr. med. Hartmut Brückmann

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Radiologie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise