PMID- 19195518
OWN - NLM
STAT- MEDLINE
DCOM- 20090319
LR  - 20211020
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 103
IP  - 4
DP  - 2009 Feb 15
TI  - Diagnostic and prognostic utility of cardiovascular magnetic resonance imaging in 
      light-chain cardiac amyloidosis.
PG  - 544-9
LID - 10.1016/j.amjcard.2008.09.105 [doi]
AB  - Although the presence of abnormal late gadolinium enhancement (LGE) in cardiac 
      amyloidosis has been well established, its prognostic implication and utility to 
      identify cardiac involvement in patients with systemic amyloidosis is unknown. 
      The aim of this study was to assess the diagnostic and prognostic significance of 
      cardiovascular magnetic resonance imaging in patients with amyloid light-chain 
      amyloidosis but unknown cardiac involvement. Cardiovascular magnetic resonance 
      imaging with LGE was performed in 28 patients with systemic amyloidosis. The 
      presence of cardiac amyloidosis was determined by separate clinical evaluation. 
      The performance of LGE for the prediction of cardiac amyloidosis and prognostic 
      implications of LGE were determined. LGE was observed in 19 patients (68%). The 
      sensitivity, specificity, positive predictive value, and negative predictive 
      value of LGE for the identification of clinical cardiac involvement were 86%, 
      86%, 95%, and 67%, respectively. During a median follow-up period of 29 months, 
      there were 5 deaths (82% survival). LGE itself did not predict survival (p = 
      0.62). LGE volume was positively correlated with serum level of B-type 
      natriuretic peptide (BNP; R = 0.64, p < or =0.001), and in multivariate analysis, 
      LGE volume proved the strongest independent predictor of BNP. BNP was correlated 
      with New York Heart Association class (p = 0.03). Reduced right ventricular 
      end-diastolic volume (p <0.01) and stroke volume (p = 0.02) were associated with 
      mortality. In conclusion, in patients with systemic amyloidosis, LGE is highly 
      sensitive and specific for the identification of cardiac involvement but does not 
      predict survival. LGE is strongly correlated with heart failure severity as 
      assessed by BNP.
FAU - Ruberg, Frederick L
AU  - Ruberg FL
AD  - Department of Medicine, Boston University School of Medicine, Massachusetts, USA. 
      frruberg@bu.edu
FAU - Appelbaum, Evan
AU  - Appelbaum E
FAU - Davidoff, Ravin
AU  - Davidoff R
FAU - Ozonoff, Al
AU  - Ozonoff A
FAU - Kissinger, Kraig V
AU  - Kissinger KV
FAU - Harrigan, Caitlin
AU  - Harrigan C
FAU - Skinner, Martha
AU  - Skinner M
FAU - Manning, Warren J
AU  - Manning WJ
LA  - eng
GR  - P01 HL68705/HL/NHLBI NIH HHS/United States
GR  - T32 HL007224/HL/NHLBI NIH HHS/United States
GR  - T32 HL007224-29/HL/NHLBI NIH HHS/United States
GR  - P01 HL068705/HL/NHLBI NIH HHS/United States
GR  - T32 HL07224-29/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20081225
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Aged
MH  - Amyloidosis/*diagnosis
MH  - Female
MH  - Gadolinium
MH  - Heart Diseases/*diagnosis
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Severity of Illness Index
PMC - PMC2680134
MID - NIHMS95441
COIS- Disclosures: No conflicts of Interest are declared
EDAT- 2009/02/07 09:00
MHDA- 2009/03/20 09:00
PMCR- 2010/02/15
CRDT- 2009/02/07 09:00
PHST- 2008/08/08 00:00 [received]
PHST- 2008/09/29 00:00 [revised]
PHST- 2008/09/29 00:00 [accepted]
PHST- 2009/02/07 09:00 [entrez]
PHST- 2009/02/07 09:00 [pubmed]
PHST- 2009/03/20 09:00 [medline]
PHST- 2010/02/15 00:00 [pmc-release]
AID - S0002-9149(08)01899-7 [pii]
AID - 10.1016/j.amjcard.2008.09.105 [doi]
PST - ppublish
SO  - Am J Cardiol. 2009 Feb 15;103(4):544-9. doi: 10.1016/j.amjcard.2008.09.105. Epub 
      2008 Dec 25.