F Legou1, V Tacher1, T Damy2, V Planté-Bordeneuve3, S Rappeneau4, N Benhaiem5, J Rosso4, E Itti4, A Luciani1, H Kobeiter1, A Rahmouni1, J-F Deux6. 1. Radiology Department, Henri-Mondor Hospital, Paris Est Créteil University, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France. 2. Amyloid Network, Henri-Mondor Hospital, Paris Est Créteil University, 94010 Créteil, France; Cardiology Department, Henri-Mondor Hospital, Paris Est Créteil University, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France. 3. Amyloid Network, Henri-Mondor Hospital, Paris Est Créteil University, 94010 Créteil, France; Neurology department, Henri-Mondor Hospital, Paris Est Créteil University, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France. 4. Nuclear Medecine department, Henri-Mondor Hospital, Paris Est Créteil University, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France. 5. Pathology department, Henri-Mondor Hospital, Paris Est Créteil University, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France. 6. Radiology Department, Henri-Mondor Hospital, Paris Est Créteil University, Assistance publique-Hôpitaux de Paris, 94010 Créteil, France; Amyloid Network, Henri-Mondor Hospital, Paris Est Créteil University, 94010 Créteil, France. Electronic address: jean-francois.deux@hmn.aphp.fr.
Abstract
PURPOSE: To detect if a difference of T2 ratio, defined as the signal intensity (SI) of the myocardium divided by the SI of the skeletal muscle on T2-weigthed cardiac magnetic resonance (CMR) imaging, exists between patients with systemic amyloidosis, by comparison to control subjects. To determine if a relationship exists between T2 ratio and the overall mortality. MATERIALS AND METHODS: CMR imaging examinations of 73 consecutive patients (48 men, 25 women; mean age, 63 years±15[SD]) with amyloidosis and suspicion of CA and 27 control subjects were retrospectively analyzed after institutional review board approval. Final diagnosis of CA was retained in case of histological confirmation of CA, typical pattern of CA on imaging and/or positivity of 99Technetium-hydroxymethylene diphosphonate scintigraphy. Patients were divided in 2 groups according to the presence or the absence of CA. T2 ratios were calculated in patients with and those without CA and in control subjects with using analysis of variance. Prognostic value of T2 ratio was studied with a Kaplan-Meier curve. RESULTS: Thirty-five patients (51%) had CA and 33 (49%) were free from CA. T2 ratio was lower in patients with CA (1.18±0.29) than in patients without cardiac involvement (1.37±0.35) (P=0.03) and control subjects (1.45±0.24) (P=0.004). A T2 ratio of 1.36 was the best threshold value for predicting CA with a sensitivity of 63% and a specificity of 73%. Kaplan-Meier analysis showed a significant relationship between a shortened overall survival and a T2 ratio<1.36. CONCLUSION: Patients with CA exhibit lower T2 ratio on CMR imaging by comparison with patients free of CA and control subjects.
PURPOSE: To detect if a difference of T2 ratio, defined as the signal intensity (SI) of the myocardium divided by the SI of the skeletal muscle on T2-weigthed cardiac magnetic resonance (CMR) imaging, exists between patients with systemic amyloidosis, by comparison to control subjects. To determine if a relationship exists between T2 ratio and the overall mortality. MATERIALS AND METHODS: CMR imaging examinations of 73 consecutive patients (48 men, 25 women; mean age, 63 years±15[SD]) with amyloidosis and suspicion of CA and 27 control subjects were retrospectively analyzed after institutional review board approval. Final diagnosis of CA was retained in case of histological confirmation of CA, typical pattern of CA on imaging and/or positivity of 99Technetium-hydroxymethylene diphosphonate scintigraphy. Patients were divided in 2 groups according to the presence or the absence of CA. T2 ratios were calculated in patients with and those without CA and in control subjects with using analysis of variance. Prognostic value of T2 ratio was studied with a Kaplan-Meier curve. RESULTS: Thirty-five patients (51%) had CA and 33 (49%) were free from CA. T2 ratio was lower in patients with CA (1.18±0.29) than in patients without cardiac involvement (1.37±0.35) (P=0.03) and control subjects (1.45±0.24) (P=0.004). A T2 ratio of 1.36 was the best threshold value for predicting CA with a sensitivity of 63% and a specificity of 73%. Kaplan-Meier analysis showed a significant relationship between a shortened overall survival and a T2 ratio<1.36. CONCLUSION:Patients with CA exhibit lower T2 ratio on CMR imaging by comparison with patients free of CA and control subjects.
Authors: Jean Michel Saad; Ahmed Ibrahim Ahmed; Dixitha Anugula; Yushui Han; Moath Said Alfawara; Mouaz H Al-Mallah Journal: Methodist Debakey Cardiovasc J Date: 2022-03-14