PMID- 29298704 OWN - NLM STAT- MEDLINE DCOM- 20190314 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 20 IP - 1 DP - 2018 Jan 3 TI - The prognostic value of T1 mapping and late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with light chain amyloidosis. PG - 2 LID - 10.1186/s12968-017-0419-6 [doi] LID - 2 AB - BACKGROUND: Cardiac impairment is associated with high morbidity and mortality in immunoglobulin light chain (AL) type amyloidosis, for which early identification and risk stratification is vital. For myocardial tissue characterization, late gadolinium enhancement (LGE) is a classic and most commonly performed cardiovascular magnetic resonance (CMR) parameter. T1 mapping with native T1 and extracellular volume (ECV) are recently developed quantitative parameters. We aimed to investigate the prognostic value of native T1, ECV and LGE in patients with AL amyloidosis. METHODS: Eighty-two patients (55.5 +/- 8.5 years; 52 M) and 20 healthy subjects (53.2 +/- 11.7 years; 10 M) were prospectively recruited. All subjects underwent CMR with LGE imaging and T1 mapping using a Modified Look-Locker Inversion-recovery (MOLLI) sequence on a 3 T scanner. Native T1 and ECV were measured semi-automatically using a dedicated CMR software. The left ventricular (LV) LGE pattern was classified as none, patchy, and global groups. Global LGE was considered when there was diffuse, transmural LGE in more than half of the short axis images. Follow-up was performed for all-cause mortality using Cox proportional hazards regression analysis and Kaplan-Meier survival curves. RESULTS: The patients demonstrated an increase in native T1 (1438 +/- 120 ms vs. 1283 +/- 46 ms, P = 0.001) and ECV (43.9 +/- 10.9% vs. 27.0 +/- 1.7%, P = 0.001) compared to healthy controls. Native T1, ECV and LGE showed significant correlation with Mayo Stage, and ECV and LGE showed significant correlation with echocardiographic E/E' and LV ejection fraction. During the follow-up for a median time of 8 months, 21 deaths occurred. ECV >/= 44.0% (hazard ratio [HR] 7.249, 95% confidence interval (CI) 1.751-13.179, P = 0.002) and global LGE (HR 4.804, 95% CI 1.971-12.926, P = 0.001) were independently prognostic for mortality over other clinical and imaging parameters. In subgroups with the same LGE pattern, ECV >/= 44.0% remained prognostic (log rank P = 0.029). Median native T1 (1456 ms) was not prognostic for mortality (Tarone-Ware, P = 0.069). CONCLUSIONS: During a short-term follow-up, both ECV and LGE are independently prognostic for mortality in AL amyloidosis. In patients with a similar LGE pattern, ECV remained prognostic. Native T1 was not found to be a prognostic factor. FAU - Lin, Lu AU - Lin L AD - Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Li, Xiao AU - Li X AD - Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Feng, Jun AU - Feng J AD - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Shen, Kai-Ni AU - Shen KN AD - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Tian, Zhuang AU - Tian Z AD - Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Sun, Jian AU - Sun J AD - Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Mao, Yue-Ying AU - Mao YY AD - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Cao, Jian AU - Cao J AD - Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Jin, Zheng-Yu AU - Jin ZY AD - Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. FAU - Li, Jian AU - Li J AD - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. lijian@pumch.cn. FAU - Selvanayagam, Joseph B AU - Selvanayagam JB AD - Department of Cardiovascular Medicine, Flinders University, Flinders Medical Centre, Bedford Park, Adelaide, 5042, SA, Australia. FAU - Wang, Yi-Ning AU - Wang YN AD - Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1, Shuaifuyuan, Dongcheng District, Beijing, 100730, China. wangyining@pumch.cn. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180103 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 (Contrast Media) SB - IM MH - Adult MH - Cardiomyopathies/*diagnostic imaging/mortality/physiopathology MH - Case-Control Studies MH - Cause of Death MH - China MH - Contrast Media/*administration & dosage MH - Female MH - Humans MH - Image Interpretation, Computer-Assisted MH - Immunoglobulin Light-chain Amyloidosis/*diagnostic imaging/mortality/physiopathology MH - *Magnetic Resonance Imaging, Cine MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - *Stroke Volume MH - Time Factors MH - *Ventricular Function, Left PMC - PMC5753536 OTO - NOTNLM OT - Cardiovascular magnetic resonance imaging OT - Late gadolinium enhancement OT - Light chain amyloidosis OT - T1 mapping COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: All subjects have consented to participate in this study. This research was approved by the Institutional Ethnics Committee for Human Research at Peking Union Medical College Hospital (Beijing, China). CONSENT FOR PUBLICATION: All individual person's data has consent for publication obtained from that person. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/01/05 06:00 MHDA- 2019/03/15 06:00 PMCR- 2018/01/03 CRDT- 2018/01/05 06:00 PHST- 2017/03/14 00:00 [received] PHST- 2017/11/23 00:00 [accepted] PHST- 2018/01/05 06:00 [entrez] PHST- 2018/01/05 06:00 [pubmed] PHST- 2019/03/15 06:00 [medline] PHST- 2018/01/03 00:00 [pmc-release] AID - S1097-6647(23)00539-2 [pii] AID - 419 [pii] AID - 10.1186/s12968-017-0419-6 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2018 Jan 3;20(1):2. doi: 10.1186/s12968-017-0419-6.