PMID- 35113283
OWN - NLM
STAT- Publisher
LR  - 20240220
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Linking)
DP  - 2022 Feb 3
TI  - Left atrial remodeling and the prognostic value of feature tracking derived left 
      atrial strain in patients with light-chain amyloidosis: a cardiovascular magnetic 
      resonance study.
LID - 10.1007/s10554-022-02534-x [doi]
AB  - Systemic light-chain (AL) amyloidosis is characterized by the aggregation of 
      misfolded immunoglobulin light chain, predominantly infiltrating in the heart, 
      including left atrium (LA). LA remodeling, such as increased interatrial septal 
      thickness and enlarged size, has been observed. However, LA strain assessed by 
      cardiac magnetic resonance feature tracking (CMR-FT) and its prognostic role 
      remains to be further determined. Using CMR, the current study sought to 
      investigate the characteristic of LA remodeling and the prognostic value of LA 
      strain in patients with AL. Eighty-seven consecutive patients who underwent CMR 
      with histologically confirmed systemic light-chain amyloidosis were 
      retrospectively enrolled. LA strain parameters were analyzed based on CMR-FT 
      algorithm. Amyloid infiltration and burden loads were assessed with CMR late 
      gadolinium enhancement (LGE) and extracellular volume (ECV). Patients were 
      categorized according to the extent of amyloid infiltration in cardiac 
      myocardium. The primary endpoint was defined as all-cause mortality. The 
      prognosis value of LA strain indices was evaluated using Cox proportional hazards 
      regression and Kaplan-Meier curves. Interatrial septal thickness (3 [2-5] vs. 4 
      [3-5] mm, p = 0.007) and indexed LA volume (34.6 [26.9-44.6] vs. 50.5 [36.1-58.5] 
      ml/m(2), p = 0.001) were significantly higher in patients with atrial involvement 
      (LA-LGE). Compared with patients with low amyloid burden loads (ECV group I), 
      those at moderate and high (ECV group II and III) show progressive impairment in 
      LA reservoir, conduit, and booster strains and strain rates. A total of 44 
      patients died during a median follow-up of 12 months. In multivariate analysis, 
      LA reservoir strain, New York Heart Association (NYHA), and ECV remained 
      independently associated with survival. On Kaplan-Meier analyses, low LA 
      reservoir strain (< 8.6%) increased the risk of mortality. In moderate amyloid 
      burden loads patients, low LA reservoir strain provides additive prognosis value. 
      Progress left atrial remodeling and dysfunction are common findings in AL cardiac 
      amyloidosis. The CMR-FT-derived LA reservoir strain provides independent and 
      additive prognostic value for all-cause mortality in patients with AL cardiac 
      amyloidosis.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Nature B.V.
FAU - Tan, Zekun
AU  - Tan Z
AD  - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 
      Guangdong, China.
AD  - Department of Radiology, Guangdong Provincial Key Laboratory of Artificial 
      Intelligence in Medical Image Analysis and Application, Guangdong Provincial 
      People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 
      China.
FAU - Yang, Yuelong
AU  - Yang Y
AD  - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 
      Guangdong, China.
AD  - Department of Radiology, Guangdong Provincial Key Laboratory of Artificial 
      Intelligence in Medical Image Analysis and Application, Guangdong Provincial 
      People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 
      China.
FAU - Wu, Xinyi
AU  - Wu X
AD  - Department of Radiology, Guangdong Provincial Key Laboratory of Artificial 
      Intelligence in Medical Image Analysis and Application, Guangdong Provincial 
      People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 
      China.
AD  - School of Medicine, South China University of Technology, Guangzhou, Guangdong, 
      China.
FAU - Li, Sheng
AU  - Li S
AD  - School of Medicine, South China University of Technology, Guangzhou, Guangdong, 
      China.
AD  - Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy 
      of Medical Sciences, Guangzhou, Guangdong, China.
FAU - Li, Liwen
AU  - Li L
AD  - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart 
      Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial 
      People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 
      China.
FAU - Zhong, Liye
AU  - Zhong L
AD  - Department of Hematology, Guangdong Provincial People's Hospital, Guangdong 
      Academy of Medical Sciences, Guangzhou, Guangdong, China.
FAU - Lin, Qiongwen
AU  - Lin Q
AD  - Department of Adult Echocardiography, Guangdong Cardiovascular Institute, 
      Guangdong Provincial People's Hospital, Guangdong Academy of Medicine Sciences, 
      Guangzhou, Guangdong, China.
FAU - Fei, Hongwen
AU  - Fei H
AD  - Department of Adult Echocardiography, Guangdong Cardiovascular Institute, 
      Guangdong Provincial People's Hospital, Guangdong Academy of Medicine Sciences, 
      Guangzhou, Guangdong, China.
FAU - Liao, Pengjun
AU  - Liao P
AD  - Department of Hematology, Guangdong Provincial People's Hospital, Guangdong 
      Academy of Medical Sciences, Guangzhou, Guangdong, China.
FAU - Wang, Wenjian
AU  - Wang W
AD  - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 
      Guangdong, China. wwjph@126.com.
AD  - Department of Radiology, Guangdong Provincial Key Laboratory of Artificial 
      Intelligence in Medical Image Analysis and Application, Guangdong Provincial 
      People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 
      China. wwjph@126.com.
AD  - Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy 
      of Medical Sciences, Guangzhou, Guangdong, China. wwjph@126.com.
FAU - Liu, Hui
AU  - Liu H
AUID- ORCID: 0000-0003-0148-0125
AD  - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 
      Guangdong, China. liuhuijiujiu@gmail.com.
AD  - Department of Radiology, Guangdong Provincial Key Laboratory of Artificial 
      Intelligence in Medical Image Analysis and Application, Guangdong Provincial 
      People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 
      China. liuhuijiujiu@gmail.com.
LA  - eng
GR  - 2018B030339001/Key R&D Program of Guangdong Province/
GR  - 81974262/National Natural Science Foundation of China/
GR  - 2020A1515010650/Natural Science Foundation of Guangdong Province/
PT  - Journal Article
DEP - 20220203
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
SB  - IM
OTO - NOTNLM
OT  - Cardiac amyloidosis
OT  - Cardiovascular magnetic resonance
OT  - Feature tracking
OT  - Left atrial
OT  - Strain
EDAT- 2022/02/04 06:00
MHDA- 2022/02/04 06:00
CRDT- 2022/02/03 12:17
PHST- 2021/11/29 00:00 [received]
PHST- 2022/01/20 00:00 [accepted]
PHST- 2022/02/03 12:17 [entrez]
PHST- 2022/02/04 06:00 [pubmed]
PHST- 2022/02/04 06:00 [medline]
AID - 10.1007/s10554-022-02534-x [pii]
AID - 10.1007/s10554-022-02534-x [doi]
PST - aheadofprint
SO  - Int J Cardiovasc Imaging. 2022 Feb 3. doi: 10.1007/s10554-022-02534-x.