Cardiopulmonary exercise testing in correlation with magnetic resonance imaging in patients with cardiac amyloidosis

Abstract Introduction Cardiac magnetic resonance imaging (cMRI) stands as a crucial non-invasive diagnostic tool for monitoring disease progression in individuals with cardiac amyloidosis (CA). Limited functional capacity (FC), assessed by cardiopulmonary exercise testing (CPET) has been described in CA in several studies. The aim of this study was to identify potential concurrent relationships between the two diagnostic modalities. Methods 112 patients diagnosed with cardiac amyloidosis (CA) were evaluated. Patients were aged 77 ± 7 years with 86% being male. Each participant underwent both cMRI and CPET under best medical therapy and prior to initiation of disease specific therapy. Results A mean peak oxygen consumption (VO2) of 15 ± 4 ml/kg×min, with a physical performance of 80 ± 29 watts, a ventilation to carbon dioxide relationship (VE/VCO2) slope of 39 ± 8, and a peak oxygen pulse (O2 pulse) of 11 ± 4 ml/beat were assessed. Furthermore, on cMRI, left ventricle ejection fraction (LVEF) with a mean of 49 ± 12 %, a left ventricular stroke volume (LVSV) of 85 ± 26 ml and a right ventricle ejection fraction (RVEF) of 46 ± 12 % were obtained. Pearson correlation showed a significant correlation between peak VO2 and LVEF (r = 0.421, P-value 0.001). Further, a significant correlation was observed between the peak O2 pulse and LVSV (r = 0.411, P-value 0.001). Moreover, correlations were established between RVEF and both measures of physical performance (r = 0.473, P-value 0.001) and VE/VCO2 Slope (r = 0.415, P-value 0.001), as demonstrated in Table 1. Conclusions The assessed correlations between CPET variables and cMRI parameters suggest that CPET may serve as a valuable method for assessing the prognosis and diagnosis of CA. Table 1