Key result
Cardiac amyloidosis was associated with significantly higher global extracellular volume (51.4% in advanced disease vs 26.0% in controls) and native T1, with advanced disease exhibiting a basal predominant pattern of amyloid deposition.
Why the study?
The study aimed to investigate regional amyloid burden and myocardial deformation using T1 mapping and strain values in cardiac amyloidosis patients according to late gadolinium enhancement patterns.
Does quantitative cardiac MRI (T1 mapping, ECV, and strain) identify regional amyloid burden differences in patients with cardiac amyloidosis according to LGE patterns?
Observational (n=55)
Single-blind
No
Does quantitative cardiac MRI (T1 mapping, ECV, and strain) identify regional amyloid burden differences in patients with cardiac amyloidosis according to LGE patterns?
Absolute Event Rate: 51.4% vs 26%
p-value: p=<0.001
Quantitative CMR parameters, particularly ECV and native T1, can help diagnose early cardiac amyloidosis and reflect regional differences in amyloid deposition in advanced disease.
May aid early cardiac amyloidosis diagnosis; hypothesis-generating for LGE-pattern differences in amyloid burden.
Objective: This study aimed to investigate the regional amyloid burden and myocardial deformation using T1 mapping and strain values in patients with cardiac amyloidosis (CA) according to late gadolinium enhancement (LGE) patterns. Materials and Methods: Forty patients with CA were divided into 2 groups per LGE pattern, and 15 healthy subjects were enrolled. Global and regional native T1 and T2 mapping, extracellular volume (ECV), and cardiac magnetic resonance (CMR)feature tracking strain values were compared in an intergroup and interregional manner. Results: Of the patients with CA, 32 had diffuse global LGE (group 2), and 8 had focal patchy or no LGE (group 1). Global native T1, T2, and ECV were significantly higher in groups 1 and 2 than in the control group (native T1: 1384.4 ms vs. 1466.8 ms vs. 1230.5 ms; T2: 53.8 ms vs. 54.2 ms vs. 48.9 ms; and ECV: 36.9% vs. 51.4% vs. 26.0%, respectively; all, p < 0.001). Basal ECV (53.7%) was significantly higher than the mid and apical ECVs (50.1% and 50.0%, respectively; p < 0.001) in group 2. Basal and mid peak radial strains (PRSs) and peak circumferential strains (PCSs) were significantly lower than the apical PRS and PCS, respectively (PRS, 15.6% vs. 16.7% vs. 26.9%; and PCS,.0%; all, p < 0.001). Basal ECV and basal strain (2-dimensional PRS) in group 2 showed a significant negative correlation (r = -0.623, p < 0.001). Group 1 showed no regional ECV differences (basal, 37.0%; mid, 35.9%; and apical, 38.3%; p = 0.184). Conclusion: Quantitative T1 mapping parameters such as native T1 and ECV may help diagnose early CA. ECV, in particular, can reflect regional differences in the amyloid deposition in patients with advanced CA, and increased basal ECV is related to decreased basal strain. Therefore, quantitative CMR parameters may help diagnose CA and determine its severity in patients with or without LGE.
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Kim et al. (2021) conducted an observational in Cardiac Amyloidosis (n=55). Cardiac amyloidosis (diffuse global LGE vs focal patchy/no LGE) vs. Healthy controls was evaluated on Global extracellular volume (ECV) (p=<0.001). Cardiac amyloidosis was associated with significantly higher global extracellular volume (51.4% in advanced disease vs 26.0% in controls) and native T1, with advanced disease exhibiting a basal predominant pattern of amyloid deposition.
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