Key result
Higher native T1, ECV, and lower T2 ratio on CMR predict worse mortality in cardiac amyloidosis.
Why the study?
With the emergence of novel therapies, there is a growing interest in prognosticating cardiac amyloidosis using cardiac magnetic resonance imaging, specifically myocardial native T1, T2, and extracellular volume.
Does tissue mapping by cardiac magnetic resonance imaging improve prognostication of all-cause mortality in adult patients with amyloid cardiomyopathy?
Meta-Analysis
Does tissue mapping by cardiac magnetic resonance imaging improve prognostication of all-cause mortality in adult patients with amyloid cardiomyopathy?
Higher native T1 time, higher ECV, and lower myocardial-to-skeletal T2 ratio on CMR are associated with increased all-cause mortality in patients with cardiac amyloidosis.
May refine mortality risk stratification in cardiac amyloidosis; extends observational data but prospective validation required before practice change.
BACKGROUND: Cardiac amyloidosis is increasingly recognized as a significant contributor to cardiovascular morbidity and mortality. With the emergence of novel therapies, there is a growing interest in prognostication of patients with cardiac amyloidosis using cardiac magnetic resonance imaging (CMR). In this systematic review and meta-analysis, we aimed to examine the prognostic significance of myocardial native T1 and T2, and extracellular volume (ECV). METHODS: Observational cohort studies or single arms of clinical trials were eligible. MEDLINE, EMBASE and CENTRAL were systematically searched from their respective dates of inception to January 2023. No exclusions were made based on date of publication, study outcomes, or study language. The study populations composed of adult patients (≥18 years old) with amyloid cardiomyopathy. All studies included the use of CMR with and without intravenous gadolinium contrast administration to assess myocardial native T1 mapping, T2 mapping, and ECV in association with the pre-specified primary outcome of all-cause mortality. Data were extracted from eligible primary studies by two independent reviewers and pooled via the inverse variance method using random effects models for meta-analysis. RESULTS: = 0%) for myocardial-to-skeletal T2 ratio below the mean (vs above the mean). CONCLUSION: Higher native T1 time and ECV, and lower myocardial to skeletal T2 ratio, on CMR are associated with worse mortality in patients with cardiac amyloidosis. Therefore, tissue mapping using CMR may offer a useful non-invasive technique to monitor disease progression and determine prognosis in patients with cardiac amyloidosis.
No takes yet. Share an insight, caveat, or question.
Cai et al. (2024) conducted a meta-analysis in cardiac amyloidosis. Cardiac magnetic resonance imaging (CMR) tissue mapping was evaluated on all-cause mortality. Higher native T1 time and extracellular volume, and lower myocardial-to-skeletal T2 ratio on CMR are associated with worse mortality in patients with cardiac amyloidosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: