Details

Autor(en) / Beteiligte

• Treibel, Thomas A
• Bandula, Steve
• Fontana, Marianna
• White, Steven K
• Gilbertson, Janet A
• Herrey, Anna S
• Gillmore, Julian D
• Punwani, Shonit
• Hawkins, Philip N
• Taylor, Stuart A
• Moon, James C

Titel

Extracellular volume quantification by dynamic equilibrium cardiac computed tomography in cardiac amyloidosis

Ist Teil von

• Journal of cardiovascular computed tomography, 2015-11, Vol.9 (6), p.585-592

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2015

Quelle

ScienceDirect Pay Per View(PPV) Titles

Beschreibungen/Notizen

• Abstract Background Cardiac involvement determines outcome in patients with systemic amyloidosis. There is major unmet need for quantification of cardiac amyloid burden, which is currently only met in part through semi-quantitative bone scintigraphy or Cardiovascular Magnetic Resonance (CMR), which measures ECVCMR . Other accessible tests are needed. Objectives To develop cardiac computed tomography to diagnose and quantify cardiac amyloidosis by measuring the myocardial Extracellular Volume, ECVCT. Methods Twenty-six patients (21 male, 64 ± 14 years) with a biopsy-proven systemic amyloidosis (ATTR n = 18; AL n = 8) were compared with twenty-seven patients (19 male, 68 ± 8 years) with severe aortic stenosis (AS). All patients had undergone echocardiography, bone scintigraphy, NT-pro-BNP measurement and EQ-CMR. Dynamic Equilibrium CT (DynEQ-CT) was performed using a prospectively gated cardiac scan prior to and after (5 and 15 minutes) a standard Iodixanol (1 ml/kg) bolus to measure ECVCT . ECVCT was compared to the reference ECVCMR and conventional amyloid measures: bone scintigraphy and clinical markers of cardiac amyloid severity (NT-pro-BNP, Troponin, LVEF, LV mass, LA and RA area). Results ECVCT and ECVCMR results were well correlated (r2  = 0.85 vs r2  = 0.74 for 5 and 15 minutes post bolus respectively). ECVCT was higher in amyloidosis than AS (0.54 ± 0.11 vs 0.28 ± 0.04, p < 0. 001 ) with no overlap. ECVCT tracked clinical markers of cardiac amyloid severity (NT-pro-BNP, Troponin, LVEF, LV mass, LA and RA area), and bone scintigraphy amyloid burden (p < 0. 001). Conclusion Dynamic Equilibrium CT, a 5 minute contrast-enhanced gated cardiac CT, has potential for non-invasive diagnosis and quantification of cardiac amyloidosis.