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首页> 外文期刊>The American Journal of Cardiology >Diagnostic and prognostic utility of cardiovascular magnetic resonance imaging in light-chain cardiac amyloidosis.
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Diagnostic and prognostic utility of cardiovascular magnetic resonance imaging in light-chain cardiac amyloidosis.

机译：心血管磁共振成像在轻链心脏淀粉样变性中的诊断和预后作用。

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摘要

Although the presence of abnormal late gadolinium enhancement (LGE) in cardiac amyloidosis has been well established, its prognostic implication and utility to identify cardiac involvement in patients with systemic amyloidosis is unknown. The aim of this study was to assess the diagnostic and prognostic significance of cardiovascular magnetic resonance imaging in patients with amyloid light-chain amyloidosis but unknown cardiac involvement. Cardiovascular magnetic resonance imaging with LGE was performed in 28 patients with systemic amyloidosis. The presence of cardiac amyloidosis was determined by separate clinical evaluation. The performance of LGE for the prediction of cardiac amyloidosis and prognostic implications of LGE were determined. LGE was observed in 19 patients (68%). The sensitivity, specificity, positive predictive value, and negative predictive value of LGE for the identification of clinical cardiac involvement were 86%, 86%, 95%, and 67%, respectively. During a median follow-up period of 29 months, there were 5 deaths (82% survival). LGE itself did not predict survival (p = 0.62). LGE volume was positively correlated with serum level of B-type natriuretic peptide (BNP; R = 0.64, p < or =0.001), and in multivariate analysis, LGE volume proved the strongest independent predictor of BNP. BNP was correlated with New York Heart Association class (p = 0.03). Reduced right ventricular end-diastolic volume (p <0.01) and stroke volume (p = 0.02) were associated with mortality. In conclusion, in patients with systemic amyloidosis, LGE is highly sensitive and specific for the identification of cardiac involvement but does not predict survival. LGE is strongly correlated with heart failure severity as assessed by BNP.
机译：尽管已经很好地确定了心脏淀粉样变性中异常晚期L增强（LGE）的存在，但其在系统性淀粉样变性患者中识别心脏受累的预后意义和实用性尚不清楚。这项研究的目的是评估患有淀粉样蛋白轻链淀粉样变性但心脏受累不明的患者的心血管磁共振成像的诊断和预后意义。 LGE对28例系统性淀粉样变性患者进行了心血管磁共振成像。通过单独的临床评估确定了心脏淀粉样变性病的存在。确定了LGE预测心脏淀粉样变性的性能和LGE的预后意义。在19例患者中观察到LGE（68％）。 LGE鉴定临床心脏受累的敏感性，特异性，阳性预测值和阴性预测值分别为86％，86％，95％和67％。在29个月的中位随访期中，有5例死亡（82％存活）。 LGE本身不能预测生存（p = 0.62）。 LGE量与B型利钠肽（BNP; R = 0.64，p <或= 0.001）的血清水平呈正相关，在多变量分析中，LGE量被证明是BNP的最强独立预测因子。 BNP与纽约心脏协会的班级相关（p = 0.03）。右心室舒张末期容积减少（p <0.01）和中风容积（p = 0.02）与死亡率相关。总之，在系统性淀粉样变性患者中，LGE对心脏受累的识别高度敏感且具有特异性，但不能预测存活率。 BNP评估，LGE与心力衰竭严重程度密切相关。

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