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Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2018

Open Access 01-12-2018 | Research

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

Authors: Fourat Ridouani, Thibaud Damy, Vania Tacher, Haytham Derbel, François Legou, Islem Sifaoui, Etienne Audureau, Diane Bodez, Alain Rahmouni, Jean-François Deux

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2018

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Abstract

Background

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).

Methods

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.

Results

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).

Conclusions

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

Trial Registration and unique number: CNIL cardio 1778041. Date of registration: 20 December 2012.
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Metadata
Title
Myocardial native T2 measurement to differentiate light-chain and transthyretin cardiac amyloidosis and assess prognosis
Authors
Fourat Ridouani
Thibaud Damy
Vania Tacher
Haytham Derbel
François Legou
Islem Sifaoui
Etienne Audureau
Diane Bodez
Alain Rahmouni
Jean-François Deux
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2018
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/s12968-018-0478-3

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