Chemotherapy significantly reduced right ventricular extracellular volume fraction from 53.9% to 51.6% and improved longitudinal strain in patients with light-chain cardiac amyloidosis.
Observational (n=111)
Sí
Does cardiac magnetic resonance imaging effectively monitor tissue characteristics and ventricular functional recovery in patients with light-chain cardiac amyloidosis undergoing chemotherapy?
Cardiac magnetic resonance is an effective tool for monitoring the regression of cardiac amyloid deposition and ventricular functional recovery in patients with AL-CA undergoing chemotherapy.
Tasa de eventos absoluta: 51.6% vs 53.9%
valor p: p=0.048
Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with lightchain cardiac amyloidosis (AL-CA).This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods:In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 interquartile range, 49-63 years).Patients underwent longitudinal monitoring using biomarkers and CMR imaging.At followup after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy.Changes in CMR findings across therapies and differences between response groups were analyzed.Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 3.5 ms vs. 44.6 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%;P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%;P = 0.048).These changes were more pronounced in the superior-response group.Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% interquartile range, -8.7%-1.1% vs. 1.7% -5.5%-7.1%;P = 0.017) and left ventricular ECV (-2.0%-6.0%-1.3% vs. 2.0% -3.0%-5.0%;P = 0.01) compared with those with inferior response.Conclusion: Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV.CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.
Guo et al. (Mon,) conducted a observational in Light-chain cardiac amyloidosis (AL-CA) (n=111). Chemotherapy (bortezomib- or melphalan-based) vs. Baseline (pre-chemotherapy) was evaluated on Right ventricular extracellular volume fraction (RV ECV) (p=0.048). Chemotherapy significantly reduced right ventricular extracellular volume fraction from 53.9% to 51.6% and improved longitudinal strain in patients with light-chain cardiac amyloidosis.
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