Key result
High left ventricular extracellular volume (>48%) on cardiac MRI identified a high-risk cohort with 74% MACE, whereas normal volume (≤32%) identified a cohort without any MACE during follow-up.
Why the study?
In systemic light-chain amyloidosis, cardiac involvement portends poor prognosis, and using MRI myocardial characteristics to detect early alterations, monitor treatment response, and predict MACE risk required evaluation.
Does left ventricular extracellular volume (ECV) on MRI predict major adverse cardiac events and detect early myocardial alterations in patients with systemic AL amyloidosis?
Population
80 participants with recently diagnosed AL amyloidosis
Comparison
AL cardiomyopathy vs AL-non-CMP
Design
Prospective cohort study
Authors
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May support early MRI monitoring in AL amyloidosis; hypothesis-generating for MACE prediction and therapy response.
Cohort (n=80)
Yes
Does left ventricular extracellular volume (ECV) on MRI predict major adverse cardiac events and detect early myocardial alterations in patients with systemic AL amyloidosis?
Absolute Event Rate: 74% vs 0%
p-value: p=<0.001
In systemic AL amyloidosis, LV ECV on MRI detects subclinical cardiomyopathy, tracks treatment response, and provides excellent risk stratification for MACE beyond the standard Mayo AL stage.
Clerc et al. (2023) conducted a cohort in Systemic light-chain (AL) amyloidosis (n=80). Left ventricular extracellular volume (LV ECV) >48% vs. LV ECV ≤32% was evaluated on Major adverse cardiac events (MACE) (p=<0.001). High left ventricular extracellular volume (>48%) on cardiac MRI identified a high-risk cohort with 74% MACE, whereas normal volume (≤32%) identified a cohort without any MACE during follow-up.
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