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Volume 18 Supplement 1

19th Annual SCMR Scientific Sessions

  • Poster presentation
  • Open Access

Clinical characteristics and predictors of mortality in patients with normal wall thickness cardiac amyloidosis

  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Journal of Cardiovascular Magnetic Resonance201618 (Suppl 1) :P131

https://doi.org/10.1186/1532-429X-18-S1-P131

  • Published:

Keywords

  • Chronic Kidney Disease
  • Multiple Myeloma
  • Wall Thickness
  • Myeloma
  • Amyloidosis

Background

Clinical features and prognosis of Cardiac amyloidosis (CA) with normal wall thickness (NWT) have not been well elucidated.

Methods

305 patients with multiple myeloma undergoing cardiac MRI for suspected amyloidosis were consecutively enrolled. 251 patients underwent gadolinium study. Increased wall thickness was defined as left ventricular wall thickness >12 mm on CMR.

Results

74 patients (29%) had gadolinium enhancement pattern consistent with CA on CMR (31% with NWT). With endomyocardial biopsy as the gold standard, amyloid pattern on CMR (LGE+) had sensitivity and negative predictive values of 100%; specificity and positive predictive values of 80% and 81% with an AUC 0.9 for CA. There was no difference between CA patients with NWT and increased wall thickness in age (60 vs. 62 years; p = 0.56);) EF (60+11 vs 59+13;p = 0.7) IgA (72 vs. 56;p = 0.07); hypertension (52% vs. 33%; p = 0.8),diabetes (17% vs. 22%; p = 0.9);chronic kidney disease (43% vs 28%; p = 0.2) and low voltage EKG (23% vs. 26%; p =0.7). There was a difference between the two groups in the following variables:female gender (60% vs. 23%; p-0.007), WT (0.97+0.1 vs. 1.5+0.2;P < 0.0001) EDV (109+55 vs 86+45;p = 0.05); BNP (249 vs 629;p = 0.01); lambda light chains (6.8 vs 2.6; p = 0.04). There was no difference in the median survival between the two groups (50%vs. 52%; log rank p value=0.9); median survival times (1215 vs. 1450 days; p =0.6).

Conclusions

NWT CA has unique clinical and biochemical profile compared to patients with increased wall thickness CA. Since prognosis is no different than patients with increased wall thickness CA, LGE CMR and biochemical markers can help in early detection and risk stratification of this high risk subgroup.

Authors’ Affiliations

(1)
Cardiology, UAMS, Little Rock, AR, USA

Copyright

© Bhatti et al. 2016

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/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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