Heart failure & cardiomyopathies
Quantification of right ventricular amyloid burden with 18F-florbetapir positron emission tomography/computed tomography and its association with right ventricular dysfunction and outcomes in light-chain amyloidosis
Authors' conclusion
This study shows for the first time that 18F-florbetapir PET/CT identifies early RV amyloid in systemic AL amyloidosis prior to alterations in RV structure and function. Increasing RV amyloid on 18F-florbetapir PET/CT is associated with worse RV structure and function, predicts RV dysfunction, and predicts MACE.
Study context
- Population
- Patients with systemic light-chain (AL) amyloidosis undergoing 18F-florbetapir PET/CT, MRI and echocardiographymedian age 62 y, 55% male
- Participants
- 106 patients
- Outcome
- RV amyloid on 18F-florbetapir PET/CT
Main finding
As reported in the abstract
- Right ventricular (RV) amyloid identified, with cardiac involvement by conventional criteria
- 63%
- RV amyloid identified, without cardiac involvement by conventional criteria
- 40%
- RV amyloid burden correlated with RV ejection fraction (EF), RV free wall longitudinal strain (FWLS), RV wall thickness, RV mass index, NT-proBNP, troponin T, left ventricular (LV) amyloid and lung amyloid
- each P < 0.001
- Multivariable: RV amyloid burden, but not LV or lung amyloid burden, predicted RV dysfunction (EF)
- P = 0.014
- Multivariable: RV amyloid burden, but not LV or lung amyloid burden, predicted RV dysfunction (FWLS)
- P < 0.001
Observational data: associations, not effects.
Further findings
MACE (death, HF hospitalization, cardiac transplantation) · median follow-up 28 months
- RV amyloid burden predicted MACE
- P < 0.001
Original publication
Quantification of right ventricular amyloid burden with 18F-florbetapir positron emission tomography/computed tomography and its association with right ventricular dysfunction and outcomes in light-chain amyloidosis. Eur Heart J Cardiovasc Imaging. Published 9 January 2024. doi:10.
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