Details

Autor(en) / Beteiligte

• Boynton, Samuel J., MD
• Geske, Jeffrey B., MD
• Dispenzieri, Angela, MD
• Syed, Imran S., MD
• Hanson, Theodore J., MD
• Grogan, Martha, MD
• Araoz, Philip A., MD

Titel

LGE Provides Incremental Prognostic Information Over Serum Biomarkers in AL Cardiac Amyloidosis

Ist Teil von

• JACC. Cardiovascular imaging, 2016-06, Vol.9 (6), p.680-686

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• Abstract Objectives This study sought to determine the prognostic value of cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) in amyloid light chain (AL) cardiac amyloidosis. Background Cardiac involvement is the major determinant of mortality in AL amyloidosis. CMR LGE is a marker of amyloid infiltration of the myocardium. The purpose of this study was to evaluate retrospectively the prognostic value of CMR LGE for determining all-cause mortality in AL amyloidosis and to compare the prognostic power with the biomarker stage. Methods Seventy-six patients with histologically proven AL amyloidosis underwent CMR LGE imaging. LGE was categorized as global, focal patchy, or none. Global LGE was considered present if it was visualized on LGE images or if the myocardium nulled before the blood pool on a cine multiple inversion time (TI) sequence. CMR morphologic and functional evaluation, echocardiographic diastolic evaluation, and cardiac biomarker staging were also performed. Subjects’ charts were reviewed for all-cause mortality. Cox proportional hazards analysis was used to evaluate survival in univariate and multivariate analysis. Results There were 40 deaths, and the median study follow-up period was 34.4 months. Global LGE was associated with all-cause mortality in univariate analysis (hazard ratio = 2.93; p < 0.001). In multivariate modeling with biomarker stage, global LGE remained prognostic (hazard ratio = 2.43; p = 0.01). Conclusions Diffuse LGE provides incremental prognosis over cardiac biomarker stage in patients with AL cardiac amyloidosis.