PMID- 32498919
OWN - NLM
STAT- MEDLINE
DCOM- 20210113
LR  - 20240329
IS  - 1876-7591 (Electronic)
IS  - 1936-878X (Print)
IS  - 1876-7591 (Linking)
VI  - 13
IP  - 6
DP  - 2020 Jun
TI  - Native T1 Mapping, Extracellular Volume Mapping, and Late Gadolinium Enhancement 
      in Cardiac Amyloidosis: A Meta-Analysis.
PG  - 1299-1310
LID - S1936-878X(20)30304-1 [pii]
LID - 10.1016/j.jcmg.2020.03.010 [doi]
AB  - OBJECTIVES: This study aimed to compare the diagnostic and prognostic performance 
      of native T1 mapping (T1), extracellular volume (ECV) mapping, and late 
      gadolinium enhancement (LGE) imaging for evaluating cardiac amyloidosis (CA). 
      BACKGROUND: CA is a progressive infiltrative process in the extracellular space 
      that is often underdiagnosed and holds a poor prognosis. Cardiac magnetic 
      resonance (CMR) offers novel techniques for detecting and quantifying the disease 
      burden of CA. METHODS: We searched PubMed for published studies using native T1, 
      ECV, or LGE to diagnose and prognosticate CA. A total of 18 diagnostic (n = 
      2,015) and 13 prognostic studies (n = 1,483) were included for analysis. Pooled 
      sensitivities, specificities, diagnostic odds ratios (DORs) of all diagnostic 
      tests were assessed by bivariate analysis. Pooled hazard ratios (HRs) for 
      mortality for the 3 techniques were determined. RESULTS: Bivariate comparison 
      showed that ECV (DOR: 84.6; 95% confidence interval [CI]: 30.3 to 236.2) had a 
      significantly higher DOR for CA than LGE (DOR: 20.1; 95% CI: 9.1 to 44.1; 
      p = 0.03 vs. ECV). There was no significant difference between LGE and native T1 
      for sensitivity, specificity, and DOR. HR was significantly higher for ECV (HR: 
      4.27; 95% CI: 2.87 to 6.37) compared with LGE (HR: 2.60; 95% CI: 1.90 to 3.56; 
      p = 0.03 vs. ECV) and native T1 (HR: 2.04; 95% CI: 1.24 to 3.37; p = 0.01 vs. 
      ECV). CONCLUSIONS: ECV demonstrates a higher diagnostic OR for assessing cardiac 
      amyloid than LGE and a higher HR for adverse events compared with LGE and native 
      T1. In addition, native T1 showed similar sensitivity and specificity as ECV and 
      LGE without requiring contrast material. Although limited by study heterogeneity, 
      this meta-analysis suggests that ECV provides high diagnostic and prognostic 
      utility for the assessment of cardiac amyloidosis.
CI  - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Pan, Jonathan A
AU  - Pan JA
AD  - Cardiovascular Division, Department of Medicine, University of Virginia, 
      Charlottesville.
FAU - Kerwin, Matthew J
AU  - Kerwin MJ
AD  - Cardiovascular Division, Department of Medicine, University of Virginia, 
      Charlottesville.
FAU - Salerno, Michael
AU  - Salerno M
AD  - Cardiovascular Division, Department of Medicine, University of Virginia, 
      Charlottesville; Department of Radiology and Medical Imaging, University of 
      Virginia Health System, Charlottesville, Virginia; Department of Biomedical 
      Engineering, University of Virginia, Charlottesville, Virginia. Electronic 
      address: ms5pc@virginia.edu.
LA  - eng
GR  - R01 HL131919/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - JACC Cardiovasc Imaging
JT  - JACC. Cardiovascular imaging
JID - 101467978
RN  - AU0V1LM3JT (Gadolinium)
RN  - Amyloidosis, Hereditary, Transthyretin-Related
SB  - IM
CIN - JACC Cardiovasc Imaging. 2020 Jun;13(6):1311-1313. PMID: 32498920
MH  - Adult
MH  - Aged
MH  - Amyloid Neuropathies, Familial/*diagnostic imaging/pathology/physiopathology
MH  - Cardiomyopathies/*diagnostic imaging/pathology/physiopathology
MH  - Female
MH  - Gadolinium/*administration & dosage
MH  - Humans
MH  - Immunoglobulin Light-chain Amyloidosis/*diagnostic 
      imaging/pathology/physiopathology
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Reproducibility of Results
MH  - Stroke Volume
MH  - Ventricular Function, Left
PMC - PMC7340140
MID - NIHMS1590978
OTO - NOTNLM
OT  - amyloid
OT  - cardiac
OT  - extracellular volume
OT  - late gadolinium enhancement
OT  - magnetic resonance
OT  - mapping
OT  - native T1
COIS- Disclosures: There are no conflicts of interest regarding the content of this 
      manuscript.
EDAT- 2020/06/06 06:00
MHDA- 2021/01/14 06:00
PMCR- 2021/06/01
CRDT- 2020/06/06 06:00
PHST- 2020/01/21 00:00 [received]
PHST- 2020/03/09 00:00 [revised]
PHST- 2020/03/20 00:00 [accepted]
PHST- 2020/06/06 06:00 [entrez]
PHST- 2020/06/06 06:00 [pubmed]
PHST- 2021/01/14 06:00 [medline]
PHST- 2021/06/01 00:00 [pmc-release]
AID - S1936-878X(20)30304-1 [pii]
AID - 10.1016/j.jcmg.2020.03.010 [doi]
PST - ppublish
SO  - JACC Cardiovasc Imaging. 2020 Jun;13(6):1299-1310. doi: 
      10.1016/j.jcmg.2020.03.010.