Regional myocardial microvascular dysfunction in cardiac amyloid light-chain amyloidosis: assessment with 3T cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Lin-yi Wen¹  Xi Liu¹  Qin Zhang¹  Rui Li²  Zhi-gang Yang³  Hua-yan Xu³  Ying-kun Guo⁴ 

[1] Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, 610041, Chengdu, Sichuan, China;Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, 610041, Chengdu, Sichuan, China;Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, 637000, Nanchong, Sichuan, China;Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, 610041, Chengdu, Sichuan, China;National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 17# Section 3 South Renmin Road, 610041, Chengdu, Sichuan, China;Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, 610041, Chengdu, Sichuan, China;

关键词: Amyloid light-chain cardiac amyloidosis;    Cardiovascular magnetic resonance;    Perfusion imaging;    Left ventricular function;    Coronary microvascular function;   

DOI  :  10.1186/s12968-016-0240-7

 received in 2015-12-23, accepted in 2016-03-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundCoronary microvascular dysfunction is highly prevalent in patients with amyloid light-chain (AL) cardiac amyloidosis (AL-CA). The aim of this study was to clarify the feasibility of first-pass perfusion imaging using 3 T cardiovascular magnetic resonance (CMR) for evaluating the difference in left ventricular (LV) regional myocardial microvascular function among normal subjects and in patients with AL-CA. The amyloidosis patients were classified into those with impaired systolic function [LV ejection fraction (LVEF) < 50 %] and those with preserved systolic function.MethodsIn total, 32 patients with biopsy-proven AL-CA, including 11 AL-CA patients with systolic dysfunction, 21 AL-CA patients with preserved systolic function, and 25 healthy subjects, underwent CMR examination. LV regional myocardial perfusion parameters included upslope, time to maximum signal intensity (TTM) and max signal intensity (MaxSI) were compared among the three patient groups. Receiver operating characteristic analysis was performed to determine whether perfusion parameters could be used in discriminating regional myocardial microvascularity between AL-CA patients and normal subjects.ResultsThe patients with AL-CA had significantly reduced first-pass perfusion upslope and MaxSI, and increased TTM compared with the normal subjects (all P < 0.01). Compared with the patients with AL-CA and preserved LVEF, the patients with AL-CA and impaired systolic function had a longer TTM in the basal (47.05 ± 16.59 vs. 39.68 ± 19.11; P = 0.002) and mid-ventricular (44.61 ± 16.34 vs. 37.74 ± 18.25; P = 0.002) segments; lower upslope in the basal (2.41 ± 1.32 vs. 3.60 ± 1.68; P < 0.0001), mid-ventricular (2.82 ± 1.34 vs. 4.15 ± 2.02; P < 0.0001), and apical (3.71 ± 1.38 vs. 4.97 ± 2.55; P = 0.004) segments; and lower MaxSI (31.67 ± 15.23 vs. 37.96 ± 11.15; P < 0.0001) in the basal segment. The ROC curve analysis revealed that the first-pass upslope, TTM, and MaxSI may be used as indicators for differentiating microcirculation between AL-CA patients with preserved or impaired systolic function and normal subjects.ConclusionsThe differences in LV regional myocardial microvascular function among normal subjects, AL-CA patients with systolic dysfunction, and AL-CA patients with preserved systolic function can be monitored using first-pass perfusion CMR.

【 授权许可】

CC BY   
© Li et al. 2016