Heart failure & cardiomyopathies
Myocardial Characteristics, Cardiac Structure, and Cardiac Function in Systemic Light-Chain Amyloidosis
Authors' conclusion
In patients with systemic AL amyloidosis, ECV detects subclinical myocardial alterations. With therapy, ECV tends to increase at 6 months and returns to values unchanged from baseline at 12 months, whereas GLS improves at 6 and 12 months in participants with AL-CMP. ECV and GLS offer additional prognostic performance over Mayo stage.
Study context
- Population
- Recently diagnosed systemic light-chain (AL) amyloidosis; cardiac magnetic resonance imaging (MRI) at baseline, 6 months (all) and 12 months (AL-CMP)
- Participants
- 80 participants
- Exposure
- AL-CMP vs AL-non-CMP
- Outcome
- Abnormal ECV (>32%) at baseline
Main finding
As reported in the abstract
AL-CMP
all
AL-non-CMP
47%
- Extracellular volume (ECV) and global longitudinal strain (GLS) strongly associated with major adverse cardiac events (MACE)
- P < 0.001
- ECV and GLS improved prognostic value when added to Mayo stage
- P ≤ 0.002
- MACE in participants with ECV ≤32%
- 0
- MACE in participants with ECV >48%
- 74%
Observational data: associations, not effects.
Further findings
Change in ECV · 6 months
- ECV tended to increase (median +2%), AL-CMP
- P = 0.120
- ECV tended to increase (median +2%), AL-non-CMP
- P = 0.018
- ECV returned to baseline at 12 months in AL-CMP
Change in GLS, AL-CMP · 6 and 12 months
- GLS improved at 6 months (median −0.6%)
- P = 0.048
- GLS improved at 12 months (median −1.2%)
- P < 0.001
Original publication
Myocardial Characteristics, Cardiac Structure, and Cardiac Function in Systemic Light-Chain Amyloidosis. JACC Cardiovasc Imaging. Published 10 July 2024. doi:10.
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