PMID- 19032744
OWN - NLM
STAT- MEDLINE
DCOM- 20090122
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 10
IP  - 1
DP  - 2008 Nov 25
TI  - Cardiovascular magnetic resonance and prognosis in cardiac amyloidosis.
PG  - 54
LID - 10.1186/1532-429X-10-54 [doi]
AB  - BACKGROUND: Cardiac involvement is common in amyloidosis and associated with a 
      variably adverse outcome. We have previously shown that cardiovascular magnetic 
      resonance (CMR) can assess deposition of amyloid protein in the myocardial 
      interstitium. In this study we assessed the prognostic value of late gadolinium 
      enhancement (LGE) and gadolinium kinetics in cardiac amyloidosis in a prospective 
      longitudinal study. MATERIALS AND METHODS: The pre-defined study end point was 
      all-cause mortality. We prospectively followed a cohort of 29 patients with 
      proven cardiac amyloidosis. All patients underwent biopsy, 2D-echocardiography 
      and Doppler studies, 123I-SAP scintigraphy, serum NT pro BNP assay, and CMR with 
      a T1 mapping method and late gadolinium enhancement (LGE). RESULTS: Patients with 
      were followed for a median of 623 days (IQ range 221, 1436), during which 17 
      (58%) patients died. The presence of myocardial LGE by itself was not a 
      significant predictor of mortality. However, death was predicted by gadolinium 
      kinetics, with the 2 minute post-gadolinium intramyocardial T1 difference between 
      subepicardium and subendocardium predicting mortality with 85% accuracy at a 
      threshold value of 23 ms (the lower the difference the worse the prognosis). 
      Intramyocardial T1 gradient was a better predictor of survival than FLC response 
      to chemotherapy (Kaplan Meier analysis P = 0.049) or diastolic function 
      (Kaplan-Meier analysis P = 0.205). CONCLUSION: In cardiac amyloidosis, CMR 
      provides unique information relating to risk of mortality based on gadolinium 
      kinetics which reflects the severity of the cardiac amyloid burden.
FAU - Maceira, Alicia M
AU  - Maceira AM
AD  - Cardiac Imaging Unit - ERESA. Hospital Arnau de Vilanova, Valencia, Spain. 
      amaceira@eresa.com
FAU - Prasad, Sanjay K
AU  - Prasad SK
FAU - Hawkins, Philip N
AU  - Hawkins PN
FAU - Roughton, Michael
AU  - Roughton M
FAU - Pennell, Dudley J
AU  - Pennell DJ
LA  - eng
GR  - G7900510/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
DEP - 20081125
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
RN  - 0 (Biomarkers)
RN  - 0 (Contrast Media)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Aged
MH  - Amyloidosis/metabolism/mortality/*pathology
MH  - Biomarkers/blood
MH  - Biopsy
MH  - Cardiomyopathies/metabolism/mortality/*pathology
MH  - *Contrast Media/pharmacokinetics
MH  - Echocardiography, Doppler
MH  - Female
MH  - *Gadolinium DTPA/pharmacokinetics
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Longitudinal Studies
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/metabolism/*pathology
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Time Factors
PMC - PMC2605441
EDAT- 2008/11/27 09:00
MHDA- 2009/01/23 09:00
PMCR- 2008/11/25
CRDT- 2008/11/27 09:00
PHST- 2008/11/12 00:00 [received]
PHST- 2008/11/25 00:00 [accepted]
PHST- 2008/11/27 09:00 [pubmed]
PHST- 2009/01/23 09:00 [medline]
PHST- 2008/11/27 09:00 [entrez]
PHST- 2008/11/25 00:00 [pmc-release]
AID - S1097-6647(23)01271-1 [pii]
AID - 1532-429X-10-54 [pii]
AID - 10.1186/1532-429X-10-54 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2008 Nov 25;10(1):54. doi: 10.1186/1532-429X-10-54.