1. Cardiovascular magnetic resonance in light-chain amyloidosis to guide treatment
- Author
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Ana Martinez-Naharro, Rishi Patel, Tushar Kotecha, Nina Karia, Adam Ioannou, Aviva Petrie, Liza A Chacko, Yousuf Razvi, Sriram Ravichandran, James Brown, Steven Law, Cristina Quarta, Shameem Mahmood, Brendan Wisniowski, Silvia Pica, Sajitha Sachchithanantham, Helen J Lachmann, James C Moon, Daniel S Knight, Carol Whelan, Lucia Venneri, Hui Xue, Peter Kellman, Julian D Gillmore, Philip N Hawkins, Ashutosh D Wechalekar, and Marianna Fontana
- Subjects
Magnetic Resonance Spectroscopy ,Predictive Value of Tests ,Myocardium ,Humans ,Magnetic Resonance Imaging, Cine ,Immunoglobulin Light-chain Amyloidosis ,Heart ,Amyloidosis ,Prognosis ,Cardiology and Cardiovascular Medicine ,Magnetic Resonance Imaging - Abstract
Aims To assess the ability of cardiovascular magnetic resonance (CMR) to (i) measure changes in response to chemotherapy; (ii) assess the correlation between haematological response and changes in extracellular volume (ECV); and (iii) assess the association between changes in ECV and prognosis over and above existing predictors. Methods and results In total, 176 patients with cardiac AL amyloidosis were assessed using serial N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography, free light chains and CMR with T1 and ECV mapping at diagnosis and subsequently 6, 12, and 24 months after starting chemotherapy. Haematological response was graded as complete response (CR), very good partial response (VGPR), partial response (PR), or no response (NR). CMR response was graded by changes in ECV as progression (≥0.05 increase), stable ( Conclusions Cardiac amyloid deposits frequently regress following chemotherapy, but only in patients who achieve CR or VGPR. Changes in ECV predict outcome after adjusting for known predictors.
- Published
- 2022
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