Prognostic impact of T2-weighted CMR imaging for cardiac amyloidosis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ralf Wassmuth & Hassan Abdel-Aty & Steffen Bohl & Jeanette Schulz-Menger
- چاپ و سال / کشور: 2011
Description
Objectives Using cardiac magnetic resonance imaging (MRI) we tested the diagnostic value of various markers for amyloid infiltration. Methods We performed MRI at 1.5 T in 36 consecutive patients with cardiac amyloidosis and 48 healthy volunteers. The protocol included cine imaging, T2-weighted spin echo, T1-weighted spin echo before and early after contrast and late gadolinium enhancement. We compared the frequency of abnormalities and their relation to mortality. Results Median follow-up was 31 months. Twenty-three patients died. Mean left ventricular (LV) mass was 205± 70 g. LV ejection fraction (EF) was 55±12%. T2 ratio was 1.5±0.4. 33/36 patients had pericardial and 22/36 had pleural effusions. All but two had heterogeneous late enhancement. Surviving patients did not differ from those who had died with regard to gender, LV mass or volume. Surviving patients had a significantly higher LVEF (60.4± 9.9% vs. 51.6±11.5%; p=0.03). The deceased patients had a lower T2 ratio than those who survived (1.38±0.42 vs. 1.76±0.17; p=0.005). Low T2 was associated with shorter survival (Chi-squared 11.3; p<0.001). Cox regression analysis confirmed T2 ratio<1.5 as the only independent predictors for survival. Conclusion Cardiac amyloidosis is associated with hypointense signal on T2-weighted images. A lower T2 ratio was independently associated with shortened survival.
Eur Radiol (2011) 21:1643–1650 DOI 10.1007/s00330-011-2109-3 Received: 2 November 2010 / Revised: 31 January 2011 / Accepted: 2 February 2011 / Published online: 29 March 2011
