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Prognostic value of CMR-derived extracellular volume in AL amyloidosis: a multicenter study.
Nicol, Martin; Kitzinger, Cassiel; Baudet, Mathilde; Faradji, Alyssa; Pezel, Théo; Lavergne, David; Jaccard, Arnaud; Vergaro, Giuseppe; Aimo, Alberto; Emdin, Michele; Harel, Stephanie; Royer, Bruno; Talbot, Alexis; Bousson, Valérie; Macron, Laurent; Arnulf, Bertrand; Logeart, Damien.
Afiliação
  • Nicol M; Cardiology Department Lariboisière Saint Louis Hospital, University of Paris, France.
  • Kitzinger C; Groupe Hospitalier privé Ambroise Paré-Hartmann, Département d'Imagerie Cardiaque, Neuilly sur Seine, France.
  • Baudet M; Radiology Department Lariboisière, University of Paris, France.
  • Faradji A; Cardiology Department Lariboisière Saint Louis Hospital, University of Paris, France.
  • Pezel T; Radiology Department Lariboisière, University of Paris, France.
  • Lavergne D; Cardiology Department Lariboisière Saint Louis Hospital, University of Paris, France.
  • Jaccard A; Hematology Department, Dupuytren University Hospital, Limoges, France.
  • Vergaro G; Hematology Department, Dupuytren University Hospital, Limoges, France.
  • Aimo A; Cardiology Department, Scuola Superiore Sant'Anna and Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
  • Emdin M; Cardiology Department, Scuola Superiore Sant'Anna and Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
  • Harel S; Cardiology Department, Scuola Superiore Sant'Anna and Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
  • Royer B; Immuno-Hematology Department, Saint Louis Hospital, University of Paris, France.
  • Talbot A; Immuno-Hematology Department, Saint Louis Hospital, University of Paris, France.
  • Bousson V; Immuno-Hematology Department, Saint Louis Hospital, University of Paris, France.
  • Macron L; Radiology Department Lariboisière, University of Paris, France.
  • Arnulf B; Groupe Hospitalier privé Ambroise Paré-Hartmann, Département d'Imagerie Cardiaque, Neuilly sur Seine, France.
  • Logeart D; Immuno-Hematology Department, Saint Louis Hospital, University of Paris, France.
Amyloid ; : 1-8, 2024 Sep 25.
Article em En | MEDLINE | ID: mdl-39319571
ABSTRACT

BACKGROUND:

This study aimed to assess the prognostic value of cardiac magnetic resonance (CMR) variables and compare them with biological and echocardiographic markers in patients with AL cardiac amyloidosis (CA).

METHODS:

We conducted a prospective study across three tertiary centres, where patients underwent clinical examination, blood tests, echocardiography, and CMR. The primary endpoint was all-cause mortality.

RESULTS:

A total of 176 patients with AL CA were included, with a median age of 68 years (IQR 58-75). According to the 2004 Mayo Clinic staging, 121 patients (69%) were in stage 3. During a median follow-up of 22 months (IQR 8-48), 45 patients died, and 55 were hospitalized for heart failure. Patients who died had higher NT-proBNP and troponin levels, and lower LVEF, cardiac output, and longitudinal strain. Among CMR variables, extracellular volume (ECV) was most strongly associated with all-cause mortality. In multivariate Cox models, including Mayo Clinic staging, ECV ≥ 0.45 was independently associated with mortality (HR 2.36, CI 95% 1.47-5.60) and also with heart failure hospitalizations (HR 4.10, 95%CI 2.15-8.8).

CONCLUSION:

ECV is a powerful predictor of outcomes in AL CA, providing additional prognostic value on top of Mayo Clinic staging.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Amyloid Assunto da revista: BIOQUIMICA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Amyloid Assunto da revista: BIOQUIMICA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França País de publicação: Reino Unido