PMID- 27225804
OWN - NLM
STAT- MEDLINE
DCOM- 20171102
LR  - 20190221
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 17
IP  - 9
DP  - 2016 Sep
TI  - Clinical and prognostic utility of cardiovascular magnetic resonance imaging in 
      myeloma patients with suspected cardiac amyloidosis.
PG  - 970-7
LID - 10.1093/ehjci/jew101 [doi]
AB  - OBJECTIVES: AL amyloidosis affects up to 30% of patients with multiple myeloma 
      (MM), and cardiac involvement is associated with worse outcomes. Traditional 
      screening modalities including EKG, echocardiography and biomarkers have limited 
      value. The aim of this study was to evaluate the clinical and prognostic value of 
      late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) 
      imaging in patients with plasma cell dyscrasias and suspected cardiac amyloidosis 
      (CA). METHODS: A total of 251 consecutive patients with plasma cell dyscrasias 
      who underwent CMR were enrolled in this study. Primary endpoint was all cause 
      mortality. Clinical, ECG, echocardiographic, biomarker and CMR predictors of 
      mortality were analyzed. RESULTS: Mean age of population was 63 +/- 10 years, 36% 
      females and 19% African Americans. During a median follow-up duration of 28 
      months (IQR 5-56), there were 97 deaths (39%). Patients who died were more likely 
      to have diabetes (28% vs. 14%; P = 0.03), CAD (28% vs. 16%; P = 0.04) and CKD 
      (33% vs. 21%; P = 0.04). With endomyocardial biopsy as the gold standard (42 
      (17%) patients), amyloid pattern on CMR (LGE+) had sensitivity and negative 
      predictive values of 100%; specificity and positive predictive values of 80 and 
      81% with an AUC 0.9 for CA. History of CAD (HR 1.64, 95% CI 1.01-2.6; P = 0.04), 
      brain natriuretic peptide (HR 1.0003 95% CI 1.0001-1.0006; P = 0.004) and LGE + 
      (HR 1.72, 95% CI 1.05-2.8; P = 0.02) were independent predictors of mortality. 
      LGE+ possessed incremental prognostic value over clinical, laboratory and 
      echocardiographic variables for mortality prediction. CONCLUSIONS: CMR is a 
      clinically useful tool for diagnosis and prognostication in myeloma patients with 
      suspected CA.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2016. For permissions please email: journals.permissions@oup.com.
FAU - Bhatti, Sabha
AU  - Bhatti S
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA Department of 
      Radiology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, 
      USA sabhabhatti@hotmail.com.
FAU - Watts, Evan
AU  - Watts E
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.
FAU - Syed, Fahd
AU  - Syed F
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.
FAU - Vallurupalli, Srikanth
AU  - Vallurupalli S
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.
FAU - Pandey, Tarun
AU  - Pandey T
AD  - Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 
      Little Rock, AR, USA.
FAU - Jambekar, Kedar
AU  - Jambekar K
AD  - Department of Radiology, University of Arkansas for Medical Sciences (UAMS), 
      Little Rock, AR, USA.
FAU - Mazur, Wojciech
AU  - Mazur W
AD  - The Christ Hospital, Cincinnati, OH, USA.
FAU - Hakeem, Abdul
AU  - Hakeem A
AD  - Division of Cardiovascular Medicine, Department of Medicine, University of 
      Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20160525
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
CIN - Eur Heart J Cardiovasc Imaging. 2016 Sep;17 (9):978-80. PMID: 27378771
MH  - Aged
MH  - Amyloidosis/*diagnostic imaging/mortality/pathology
MH  - Biopsy, Needle
MH  - Cohort Studies
MH  - Echocardiography/methods
MH  - Female
MH  - *Gadolinium DTPA
MH  - Humans
MH  - Immunoglobulin Light-chain Amyloidosis
MH  - Immunohistochemistry
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/*diagnostic imaging/mortality/pathology
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - ROC Curve
MH  - *Radiographic Image Enhancement
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Survival Analysis
OTO - NOTNLM
OT  - cardiac amyloidosis
OT  - cardiovascular magnetic resonance
OT  - late gadolinium enhancement
OT  - prognosis
EDAT- 2016/05/27 06:00
MHDA- 2017/11/03 06:00
CRDT- 2016/05/27 06:00
PHST- 2015/12/31 00:00 [received]
PHST- 2016/04/15 00:00 [accepted]
PHST- 2016/05/27 06:00 [entrez]
PHST- 2016/05/27 06:00 [pubmed]
PHST- 2017/11/03 06:00 [medline]
AID - jew101 [pii]
AID - 10.1093/ehjci/jew101 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2016 Sep;17(9):970-7. doi: 10.1093/ehjci/jew101. 
      Epub 2016 May 25.