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Regional Amyloid Burden Differences Evaluated Using Quantitative Cardiac MRI in Patients with Cardiac Amyloidosis

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Author(s)
Jin Young KimYoo Jin HongKyunghwa HanHye-Jeong LeeJin HurYoung Jin KimByoung Wook Choi
Keimyung Author(s)
Kim, Jin Young
Department
Dept. of Radiology (영상의학)
Journal Title
Korean J Radiol
Issued Date
2021
Volume
22
Issue
6
Keyword
Magnetic resonance imagingMyocardiumHeartMappingExtracellular spaceFeature tracking
Abstract
Objective:
This study aimed to investigate the regional amyloid burden and myocardial deformation using T1 mapping and strain values in patients with cardiac amyloidosis (CA) according to late gadolinium enhancement (LGE) patterns.

Materials and Methods:
Forty patients with CA were divided into 2 groups per LGE pattern, and 15 healthy subjects were enrolled. Global and regional native T1 and T2 mapping, extracellular volume (ECV), and cardiac magnetic resonance (CMR)-feature tracking strain values were compared in an intergroup and interregional manner.

Results:
Of the patients with CA, 32 had diffuse global LGE (group 2), and 8 had focal patchy or no LGE (group 1). Global native T1, T2, and ECV were significantly higher in groups 1 and 2 than in the control group (native T1: 1384.4 ms vs. 1466.8 ms vs. 1230.5 ms; T2: 53.8 ms vs. 54.2 ms vs. 48.9 ms; and ECV: 36.9% vs. 51.4% vs. 26.0%, respectively; all, p < 0.001). Basal ECV (53.7%) was significantly higher than the mid and apical ECVs (50.1% and 50.0%, respectively; p < 0.001) in group 2. Basal and mid peak radial strains (PRSs) and peak circumferential strains (PCSs) were significantly lower than the apical PRS and PCS, respectively (PRS, 15.6% vs. 16.7% vs. 26.9%; and PCS, −9.7% vs. −10.9% vs. −15.0%; all, p < 0.001). Basal ECV and basal strain (2-dimensional PRS) in group 2 showed a significant negative correlation (r = −0.623, p < 0.001). Group 1 showed no regional ECV differences (basal, 37.0%; mid, 35.9%; and apical, 38.3%; p = 0.184).

Conclusion:
Quantitative T1 mapping parameters such as native T1 and ECV may help diagnose early CA. ECV, in particular, can reflect regional differences in the amyloid deposition in patients with advanced CA, and increased basal ECV is related to decreased basal strain. Therefore, quantitative CMR parameters may help diagnose CA and determine its severity in patients with or without LGE.
Keimyung Author(s)(Kor)
김진영
Publisher
School of Medicine (의과대학)
Citation
Jin Young Kim et al. (2021). Regional Amyloid Burden Differences Evaluated Using Quantitative Cardiac MRI in Patients with Cardiac Amyloidosis. Korean J Radiol, 22(6), 880–889. doi: 10.3348/kjr.2020.0579
Type
Article
ISSN
2005-8330
Source
https://www.kjronline.org/search.php?where=aview&id=10.3348/kjr.2020.0579&code=0068KJR&vmode=FULL
DOI
10.3348/kjr.2020.0579
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43686
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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