Myocardial native T2 measurement to differentiate light-chain and transthyretin cardiac amyloidosis and assess prognosis.

Myocardial native T2 measurement to differentiate light-chain and transthyretin cardiac amyloidosis and assess prognosis.
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DOI:
10.1186/s12968-018-0478-3
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发表时间:
2018-08-16
期刊:
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子:
--
通讯作者:
Deux JF
Deux JF
中科院分区:
其他
文献类型:
--
作者:
Ridouani F;Damy T;Tacher V;Derbel H;Legou F;Sifaoui I;Audureau E;Bodez D;Rahmouni A;Deux JF

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评估心肌天然 T2 测量在区分轻链 (AL) 和运甲状腺素蛋白 (ATTR) 心脏淀粉样变性 (CA) 方面的诊断和预后价值。 44 名 CA 患者(24 AL;20 ATTR)和 40 名健康受试者接受了 1.5 T 心血管磁共振 (CMR)。他们都接受了 T1 和 T2 映射(改进的 Look-Locker 反转恢复)、电影和晚期钆增强 (LGE) 成像。计算所有患者的淀粉样蛋白晚期增强查询 (QALE) 评分、心肌天然 T2、T1 和细胞外体积分数 (ECV)。在 44 名患者中,36 名(82%)在 LGE 图像上表现出增强。 AL (7.9 ± 6) 和 ATTR (10.5 ± 5) 患者的平均 QALE 评分相似 (p = 0.6)。 AL (63.2 ± 4.7 ms) 患者的心肌天然 T2 显着 (p< 0.0001) 高于 ATTR (56.2 ± 3.1 ms) 患者,并且均高于 (p< 0.001) 健康受试者 (51.1 ± 3.1 ms)。心肌原生 T2 与心肌原生 T1 高度相关(Spearman’s rho = 0.79;p < 0.001),并且在区分 AL 和 ATTR 患者方面表现出比 T1 更高的诊断性能:T2 的曲线下面积 (AUC) 为 0.94(95% CI:0.86–1,p < 0.001),AUC T1 为 0.77(95% CI:0.62–0.91,p = 0.03)。心肌天然 T2 并不影响患者的总生存率(HR 1.03 (0.94–1.12);p​​ = 0.53),而 ECV 是结果的最佳预测因子(ECV 每增加 0.1,HR 1.66 (1.24–2.22);p = 0.0006)。与 ATTR 患者相比,CA 患者的心肌天然 T2 显着增加,尤其是 AL 患者。与 ECV 相比,心肌天然 T2 不会影响 CA 患者的生存,ECV 是结果的最佳预测因子。试用注册和唯一编号:CNIL有氧运动1778041。注册日期:2012年12月20日。
To assess the diagnostic and prognosis value of myocardial native T2 measurement in the distinction between Light-chain (AL) and Transthyretin (ATTR) cardiac amyloidosis (CA). Forty-four patients with CA (24 AL; 20 ATTR) and 40 healthy subjects underwent 1.5 T cardiovascular magnetic resonance (CMR). They all underwent T1 and T2 mapping (modified Look-Locker inversion recovery), cine and late gadolinium enhancement (LGE) imaging. The Query Amyloid Late Enhancement (QALE) score, myocardial native T2, T1 and extra cellular volume fraction (ECV) were calculated for all patients. Of the 44 patients, 36 (82%) exhibited enhancement on LGE images. Mean QALE score of AL (7.9 ± 6) and ATTR (10.5 ± 5) patients were similar (p = 0.6). Myocardial native T2 was significantly (p < 0.0001) higher in AL (63.2 ± 4.7 ms) than in ATTR (56.2 ± 3.1 ms) patients, and both higher (p < 0.001) than healthy subjects (51.1 ± 3.1 ms). Myocardial native T2 was highly correlated with myocardial native T1 (Spearman’s rho = 0.79; p < 0.001) and exhibited higher diagnostic performance than T1 to separate AL and ATTR patients: the area under curve (AUC) of T2 was 0.94 (95% CI: 0.86–1, p < 0.001) and the AUC of T1 was 0.77 (95% CI: 0.62–0.91, p = 0.03). Myocardial native T2 did not impact overall survival in patients (HR 1.03 (0.94–1.12); p = 0.53) in contrast to ECV that was the best predictor of outcome (HR 1.66 per 0.1 increase in ECV (1.24–2.22); p = 0.0006). Myocardial native T2 significantly is increased in CA, especially in AL patients in comparison to ATTR patients. Myocardial native T2 does not impact survival in CA patients in contrast to ECV that was the best predictor of outcome. Trial Registration and unique number: CNIL cardio 1778041. Date of registration: 20 December 2012.
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