Myocardial Amyloid Quantification with Look-Locker Magnetic Resonance Sequence in Cardiac Amyloidosis. Diagnostic Accuracy in Clinical Practice and Histological Validation

Eduardo Pozo, Jose M. Castellano, Anubhav Kanwar, Rajiv Deochand, Mireia Castillo-Martin, Pablo Pazos-López, Carlos González-Lengua, Keren Osman, Matthew Cham, Carlos Cordon-Cardo, Jagat Narula, Valentin Fuster, Javier Sanz

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Cardiac magnetic resonance (CMR) has demonstrated its utility in the noninvasive diagnosis of cardiac amyloidosis (CA). Our aim was to evaluate the ability of standard Look-Locker sequences to quantify amyloid deposition in CA. Methods and Results: Consecutive patients referred for CMR for possible CA were retrospectively evaluated. Positive cardiac biopsy and/or typical pattern of late gadolinium enhancement were required for the diagnosis of CA. Postcontrast T1 values were obtained from Look-Locker sequences and correlated with markers of severity of disease and major events. When cardiac biopsies were available, histological validation was determined. A total of 174 patients were included. A final diagnosis of CA was reached in 37.4%. Myocardial and endocardial T1 times, as well as the respective ratios with blood and skeletal muscle, were lower among patients with CA and demonstrated good diagnostic performance. The best parameters were myocardial/blood (area under the curve 0.83; P <.001) and endocardial/blood (area under the curve 0.84; P <.001) T1 ratios. Among patients with CA, no associations were found between T1 ratios either with markers of amyloid burden or with prognostic variables. However, all T1 indexes showed significant correlations with histological quantification of amyloid deposition. Conclusions: Look-Looker derived postcontrast T1 shows good diagnostic accuracy to detect CA and correlation with histological amyloid burden.

Original languageEnglish
Pages (from-to)78-86
Number of pages9
JournalJournal of Cardiac Failure
Volume24
Issue number2
DOIs
StatePublished - Feb 2018

Keywords

  • Amyloid
  • T1 mapping
  • cardiac magnetic resonance imaging
  • histopathology

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