The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine, New York, New York; Cardiology Department, Hospital Clínico San Carlos, Madrid, Spain.
The Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine, New York, New York.
J Card Fail. 2018 Feb;24(2):78-86. doi: 10.1016/j.cardfail.2017.08.445. Epub 2017 Aug 8.
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.
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.
Look-Looker derived postcontrast T1 shows good diagnostic accuracy to detect CA and correlation with histological amyloid burden.
心脏磁共振（CMR）已证明在心脏淀粉样变性（CA）的无创诊断中有其应用价值。我们的目的是评估标准 Look-Locker 序列定量 CA 中淀粉样沉积的能力。
回顾性评估了因可能的 CA 而接受 CMR 检查的连续患者。CA 的诊断需要阳性心脏活检和/或典型的晚期钆增强模式。从 Look-Locker 序列获得对比后 T1 值，并与疾病严重程度和主要事件的标志物相关联。当有心脏活检时，确定组织学验证。共纳入 174 例患者。最终诊断为 CA 的患者占 37.4%。患有 CA 的患者的心肌和心内膜 T1 时间以及与血液和骨骼肌的相应比值均较低，具有良好的诊断性能。最佳参数为心肌/血液（曲线下面积 0.83；P<.001）和心内膜/血液（曲线下面积 0.84；P<.001）T1 比值。在患有 CA 的患者中，T1 比值与淀粉样蛋白负荷标志物或预后变量之间均无相关性。但是，所有 T1 指标均与淀粉样蛋白沉积的组织学定量显示出显著相关性。
Look-Locker 衍生的对比后 T1 对检测 CA 具有良好的诊断准确性，与组织学淀粉样蛋白负荷相关。
