Li Zheng, Yan Cheng, Hu Guo-Xiang, Zhao Rui, Jin Hang, Yun Hong, Wei Zheng, Pan Cui-Zhen, Shu Xian-Hong, Zeng Meng-Su
Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Institute of Cardiovascular Disease, Shanghai, China.
Front Radiol. 2023 Aug 3;3:1115527. doi: 10.3389/fradi.2023.1115527. eCollection 2023.
Cardiac infiltration is the major predictor of poor prognosis in patients with systemic amyloidosis, thus it becomes of great importance to evaluate cardiac involvement.
We aimed to evaluate left ventricular myocardial deformation alteration in patients with cardiac amyloidosis (CA) using layer-specific tissue tracking MR.
Thirty-nine patients with CA were enrolled. Thirty-nine normal controls were also recruited. Layer-specific tissue tracking analysis was done based on cine MR images.
Compared with the control group, a significant reduction in LV whole layer strain values (GLS, GCS, and GRS) and layer-specific strain values was found in patients with CA (all < 0.01). In addition, GRS and GLS, as well as subendocardial and subepicardial GLS, GRS, and GCS, were all diminished in patients with CA and reduced LVEF, when compared to those with preserved or mid-range LVEF (all < 0.05). GCS showed the largest AUC (0.9952, = 0.0001) with a sensitivity of 93.1% and specificity of 90% to predict reduced LVEF (<40%). Moreover, GCS was the only independent predictor of LV systolic dysfunction (Odds Ratio: 3.30, 95% CI:1.341-8.12, and = 0.009).
Layer-specific tissue tracking MR could be a useful method to assess left ventricular myocardial deformation in patients with CA.
心脏浸润是系统性淀粉样变性患者预后不良的主要预测因素，因此评估心脏受累情况变得至关重要。
我们旨在使用层特异性组织追踪磁共振成像（MR）评估心脏淀粉样变性（CA）患者左心室心肌变形的改变。
纳入39例CA患者。还招募了39名正常对照者。基于电影MR图像进行层特异性组织追踪分析。
与对照组相比，CA患者的左心室全层应变值（GLS、GCS和GRS）以及层特异性应变值显著降低（均<0.01）。此外，与左心室射血分数（LVEF）保留或处于中等范围的患者相比，CA患者且LVEF降低时，GRS和GLS以及心内膜下和心外膜下的GLS、GRS和GCS均降低（均<0.05）。GCS显示出最大的曲线下面积（AUC）（0.9952，P = 0.0001），预测LVEF降低（<40%）的敏感性为93.1%，特异性为90%。此外，GCS是左心室收缩功能障碍的唯一独立预测因素（优势比：3.30，95%置信区间：1.341 - 8.12，P = 0.009）。
层特异性组织追踪MR可能是评估CA患者左心室心肌变形的一种有用方法。
