223 Adverse functional significance of delayed enhancement on cardiac MRI in primary systemic amyloidosis
© Migrino et al; licensee BioMed Central Ltd. 2008
Published: 22 October 2008
Primary systemic amyloidosis (AL), a plasma cell dyscrasia, is often associated with a fatal outcome if there is advanced cardiac involvement. Myocardial delayed enhancement (DE) has been reported on cardiac MRI but the functional significance of such finding is not established.
Our aim is to determine the functional significance of myocardial delayed enhancement (DE) on MRI by comparing systolic and diastolic function of AL patients with delayed enhancement (DE+) versus those without (DE-) using MRI and echocardiography.
23 patients (11 females; 61 ± 10 years) with biopsy-proven AL were grouped into DE+ (N = 17, 74%) and DE- (N = 6, 26%). Left ventricular ejection fraction (LVEF) and diastolic function (early diastolic filling rate DFR and early diastolic filling volume 1/3 FF on MRI, and ratio of early transmitral inflow to mitral annular velocity E/Em and deceleration time DT on echo) were compared. Automated simple linear curve fitting of early (first 1/3) diastolic filling curve was used to calculate DFR (slope of curve) and 1/3 FF was filling volume of first 1/3 of diastole.
Delayed enhancement, present in 74% of AL patients, is associated with significant diastolic dysfunction and may be important for noninvasive evaluation of primary amyloidosis.
This article is published under license to BioMed Central Ltd.