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dc.contributor.authorLin, Lu
dc.contributor.authorLi, Xiao
dc.contributor.authorFeng, Jun
dc.contributor.authorShen, Kai-ni
dc.contributor.authorTian, Zhuang
dc.contributor.authorSun, Jian
dc.contributor.authorMao, Yue-ying
dc.contributor.authorCao, Jian
dc.contributor.authorJin, Zheng-yu
dc.contributor.authorLi, Jian
dc.contributor.authorSelvanayagam, Joseph Brindaban
dc.contributor.authorWang, Yi-ning
dc.date.accessioned2018-02-19T05:14:30Z
dc.date.available2018-02-19T05:14:30Z
dc.date.issued2018-01-03
dc.identifier.citationLin, L., Li, X., Feng, J., Shen, K., Tian, Z., Sun, J., … Wang, Y. (2018). The prognostic value of T1 mapping and late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with light chain amyloidosis. Journal of Cardiovascular Magnetic Resonance, 20(1). https://doi.org/10.1186/s12968-017-0419-6
dc.identifier.urihttps://doi.org/10.1186/s12968-017-0419-6
dc.identifier.urihttp://hdl.handle.net/2328/37756
dc.description.abstractBackground Cardiac impairment is associated with high morbidity and mortality in immunoglobulin light chain (AL) type amyloidosis, for which early identification and risk stratification is vital. For myocardial tissue characterization, late gadolinium enhancement (LGE) is a classic and most commonly performed cardiovascular magnetic resonance (CMR) parameter. T1 mapping with native T1 and extracellular volume (ECV) are recently developed quantitative parameters. We aimed to investigate the prognostic value of native T1, ECV and LGE in patients with AL amyloidosis. Methods Eighty-two patients (55.5 ± 8.5 years; 52 M) and 20 healthy subjects (53.2 ± 11.7 years; 10 M) were prospectively recruited. All subjects underwent CMR with LGE imaging and T1 mapping using a Modified Look-Locker Inversion-recovery (MOLLI) sequence on a 3 T scanner. Native T1 and ECV were measured semi-automatically using a dedicated CMR software. The left ventricular (LV) LGE pattern was classified as none, patchy, and global groups. Global LGE was considered when there was diffuse, transmural LGE in more than half of the short axis images. Follow-up was performed for all-cause mortality using Cox proportional hazards regression analysis and Kaplan-Meier survival curves. Results The patients demonstrated an increase in native T1 (1438 ± 120 ms vs. 1283 ± 46 ms, P = 0.001) and ECV (43.9 ± 10.9% vs. 27.0 ± 1.7%, P = 0.001) compared to healthy controls. Native T1, ECV and LGE showed significant correlation with Mayo Stage, and ECV and LGE showed significant correlation with echocardiographic E/E’ and LV ejection fraction. During the follow-up for a median time of 8 months, 21 deaths occurred. ECV ≥ 44.0% (hazard ratio [HR] 7.249, 95% confidence interval (CI) 1.751–13.179, P = 0.002) and global LGE (HR 4.804, 95% CI 1.971–12.926, P = 0.001) were independently prognostic for mortality over other clinical and imaging parameters. In subgroups with the same LGE pattern, ECV ≥ 44.0% remained prognostic (log rank P = 0.029). Median native T1 (1456 ms) was not prognostic for mortality (Tarone-Ware, P = 0.069). Conclusions During a short-term follow-up, both ECV and LGE are independently prognostic for mortality in AL amyloidosis. In patients with a similar LGE pattern, ECV remained prognostic. Native T1 was not found to be a prognostic factor."
dc.language.isoenen
dc.publisherBioMed Central
dc.rights© The Author(s) 2018
dc.subjectLight chain amyloidosis
dc.subjectCardiovascular magnetic resonance imaging
dc.subjectT1 mapping
dc.subjectLate gadolinium enhancement
dc.titleThe prognostic value of T1 mapping and late gadolinium enhancement cardiovascular magnetic resonance imaging in patients with light chain amyloidosis
dc.typeArticleen
dc.identifier.doihttps://doi.org/10.1186/s12968-017-0419-6
dc.date.updated2018-02-15T06:50:55Z
dc.rights.holderThe Author(s)


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