- Poster presentation
- Open Access
Revisiting morphological features of cardiac amyloid with cardiac magnetic resonance
© Pozo et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Right Ventricular
- Cardiac Magnetic Resonance
- Left Ventricular Mass
- Cardiac Amyloidosis
- Delayed Enhancement
Cardiac magnetic resonance (CMR) has become a cornerstone in the diagnosis of cardiac amyloid infiltration, not only due to the presence of typical post-contrast delayed enhancement but also because of accurate morphological characteritization.
The aim of this study is to describe morphological features of cardiac amyloidosis by CMR and to establish their diagnostic accuracy.
Consecutive patients referred for CMR for possible cardiac amyloidosis were retrospectively evaluated. The final diagnosis of cardiac amyloidosis was established in presence of a positive cardiac biopsy and/or a typical pattern of diffuse, predominantly subendocardial, delayed contrast enhancement. Indexed left ventricular (LV) and right ventricular (RV) volumes and ejection fractions, LV mass, LV basal anteroseptal and inferolateral end-diastolic wall thicknesses, and left atrial dimensions were determined from standard cine CMR images. The presence of LV hypertrophy (LVH) was defined as increased LV mass based on gender-based renference values. Relative wall thickness (RWT) was calculated as 2 times inferolateral wall thickness divided by the LV end-diastolic diameter measured on a three-chamber long-axis view. LV remodeling was categorized as: 1) Concentric hypertrophy: LVH and abnormal RWT (> 0.42); 2) Eccentric hypertrophy: LVH and normal RWT (≤ 0.42); 3) Concentric remodeling: no LVH but abnormal RWT; and 4) Normal: no LVH and normal RWT. In addition, asymmetric wall thickness was defined as a ratio between LV anteroseptal and inferolateral end-diastolic wall thicknesses ≥1.3.
Morphological findings in cine CMR.
No cardiac amyloid
Asymmetric wall thickness
RWT pattern: -Normal. -Concentric remodeling -Eccentric hypertrophy -Concentric hypertrophy
1 (2.2%) 10 (21.7%) 4 (8.7%) 31 (67.4%)
23 (35.4%) 18 (27.7%) 8 (12.3%) 16 (24.6%)
Left atrial diameter (cm)
Left atrial area (cm2)
Left atrial volume (mL/m2)
Among other several morphological findings in CMR, LVH and increased RWT were independently associated with the presence of myocardial infiltration by amyloid. Increased RWT had the highest diagnostic accuracy to identify cardiac amyloidosis.
No funding sources have to be declared.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.