Key result
MR-derived global circumferential strain predicts ~230% higher odds of reduced LVEF in cardiac amyloidosis.
Why the study?
Cardiac infiltration predicts poor prognosis in systemic amyloidosis, making it important to evaluate left ventricular myocardial deformation alteration in cardiac amyloidosis using layer-specific tissue tracking MR.
Does layer-specific tissue tracking MR detect left ventricular myocardial deformation alterations in patients with cardiac amyloidosis compared to normal controls?
Case-Control (n=78)
Blinded to clinical information
No
Does layer-specific tissue tracking MR detect left ventricular myocardial deformation alterations in patients with cardiac amyloidosis compared to normal controls?
Odds Ratio: 3.3 (95% CI 1.341–8.12)
p-value: p=0.009
Layer-specific tissue tracking MR can effectively assess left ventricular myocardial deformation and predict systolic dysfunction in patients with cardiac amyloidosis.
Layer-specific MR strain may aid CA deformation assessment; leaves open validation for prognosis or monitoring.
Background Cardiac infiltration is the major predictor of poor prognosis in patients with systemic amyloidosis, thus it becomes of great importance to evaluate cardiac involvement. Purpose We aimed to evaluate left ventricular myocardial deformation alteration in patients with cardiac amyloidosis (CA) using layer-specific tissue tracking MR. Material and Methods Thirty-nine patients with CA were enrolled. Thirty-nine normal controls were also recruited. Layer-specific tissue tracking analysis was done based on cine MR images. Results Compared with the control group, a significant reduction in LV whole layer strain values (GLS, GCS, and GRS) and layer-specific strain values was found in patients with CA (all P < 0.01). In addition, GRS and GLS, as well as subendocardial and subepicardial GLS, GRS, and GCS, were all diminished in patients with CA and reduced LVEF, when compared to those with preserved or mid-range LVEF (all P < 0.05). GCS showed the largest AUC (0.9952, P = 0.0001) with a sensitivity of 93.1% and specificity of 90% to predict reduced LVEF (<40%). Moreover, GCS was the only independent predictor of LV systolic dysfunction (Odds Ratio: 3.30, 95% CI:1.341–8.12, and P = 0.009). Conclusion Layer-specific tissue tracking MR could be a useful method to assess left ventricular myocardial deformation in patients with CA.
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Li et al. (2023) conducted a case-control in Cardiac amyloidosis (n=78). Cardiac amyloidosis vs. Healthy controls was evaluated on Prediction of reduced left ventricular ejection fraction (<40%) by global circumferential strain (GCS) (OR 3.30, 95% CI 1.341-8.12, p=0.009). Global circumferential strain assessed by layer-specific tissue tracking MR was an independent predictor of reduced left ventricular ejection fraction (<40%) in patients with cardiac amyloidosis (OR 3.30).
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