Heart failure & cardiomyopathiesCohort study
Incremental prognostic value of cardiac magnetic resonance beyond biomarker staging in transthyretin cardiac amyloidosis
- retrospectively analyzed a multicentre cohort
- internal validation via bootstrapping
- decision curve analysis
Authors' conclusion
CMR-derived ECV and LAVi were associated with incremental prognostic value in ATTR-CA beyond biomarker staging and may inform clinical risk stratification.
Study context
- Population
- ATTR-CA patients who underwent cardiac magnetic resonance (CMR) between 2007 and 2023ATTR-CA patients who underwent CMR
- Participants
- 266 patients
- Exposure
- CMR parameters incorporated into National Amyloidosis Centre (NAC) staging vs baseline model using NAC stage
Main finding
As reported in the abstract
Death · median follow-up of 20 months (IQR 8-35)
Patients who died
85 patients (32%)
Observational data: associations, not effects.
Further findings
Mortality, ECV ≥ 59% (after NAC adjustment)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| ECV ≥ 59% · independently associated with mortality after NAC adjustment | 2.45 (1.2–5.2) | P = 0.020 | |
| 0.20.5125Hazard ratio (log scale) |
Mortality, LAVi ≥ 54 mL/m² (after NAC adjustment)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| LAVi ≥ 54 mL/m² · independently associated with mortality after NAC adjustment | 2.00 (1.1–3.7) | P = 0.026 | |
| 0.20.5125Hazard ratio (log scale) |
Prognostic accuracy
- ECV and LAVi improved prognostic accuracy across all biomarker stages
Decision curve analysis: identification of high-risk patients for advanced heart failure (HF) or emerging disease-modifying therapies
- additional high-risk patients identified per 1000 with CMR alongside NAC staging
- 28
Original publication
Incremental prognostic value of cardiac magnetic resonance beyond biomarker staging in transthyretin cardiac amyloidosis. Eur Heart J Cardiovasc Imaging. Published 1 July 2026. doi:10.1093/ehjci/jeag170
Summarised from the published abstract; every number is checked against it