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6. Multiorgan ECV as measured by EQ-MRI in systemic amyloidosis

Author

Banypersad Sanjay M, Bandula Steve, Sado Daniel, Pinney Jennifer H, Gibbs Simon D, Maestrini Viviana, Fontana Marianna, White Steven K, Punwani Shonit, Taylor Stuart, Hawkins Philip N, and Moon James

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2013
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13. Comparison of T1 mapping techniques for ECV quantification. Histological validation and reproducibility of ShMOLLI versus multibreath-hold T1 quantification equilibrium contrast CMR

Author

Fontana Marianna, White Steve K, Banypersad Sanjay M, Sado Daniel M, Maestrini Viviana, Flett Andrew S, Piechnik Stefan K, Neubauer Stefan, Roberts Neil, and Moon James C

Subjects
Interstitial space, Fibrosis, CMR, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Myocardial extracellular volume (ECV) is elevated in fibrosis or infiltration and can be quantified by measuring the haematocrit with pre and post contrast T1 at sufficient contrast equilibrium. Equilibrium CMR (EQ-CMR), using a bolus-infusion protocol, has been shown to provide robust measurements of ECV using a multibreath-hold T1 pulse sequence. Newer, faster sequences for T1 mapping promise whole heart coverage and improved clinical utility, but have not been validated. Methods Multibreathhold T1 quantification with heart rate correction and single breath-hold T1 mapping using Shortened Modified Look-Locker Inversion recovery (ShMOLLI) were used in equilibrium contrast CMR to generate ECV values and compared in 3 ways. Firstly, both techniques were compared in a spectrum of disease with variable ECV expansion (n=100, 50 healthy volunteers, 12 patients with hypertrophic cardiomyopathy, 18 with severe aortic stenosis, 20 with amyloid). Secondly, both techniques were correlated to human histological collagen volume fraction (CVF%, n=18, severe aortic stenosis biopsies). Thirdly, an assessment of test:retest reproducibility of the 2 CMR techniques was performed 1 week apart in individuals with widely different ECVs (n=10 healthy volunteers, n=7 amyloid patients). Results More patients were able to perform ShMOLLI than the multibreath-hold technique (6% unable to breath-hold). ECV calculated by multibreath-hold T1 and ShMOLLI showed strong correlation (r2=0.892), little bias (bias -2.2%, 95%CI -8.9% to 4.6%) and good agreement (ICC 0.922, range 0.802 to 0.961, p2= 0.589) but better by ShMOLLI ECV (r2= 0.685). Inter-study reproducibility demonstrated that ShMOLLI ECV trended towards greater reproducibility than the multibreath-hold ECV, although this did not reach statistical significance (95%CI -4.9% to 5.4% versus 95%CI -6.4% to 7.3% respectively, p=0.21). Conclusions ECV quantification by single breath-hold ShMOLLI T1 mapping can measure ECV by EQ-CMR across the spectrum of interstitial expansion. It is procedurally better tolerated, slightly more reproducible and better correlates with histology compared to the older multibreath-hold FLASH techniques.

Published
2012
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15. T1 mapping and survival in systemic light-chain amyloidosis

Author

Banypersad, Sanjay M., Fontana, Marianna, Maestrini, Viviana, Sado, Daniel M., Captur, Gabriella, Petrie, Aviva, Piechnik, Stefan K., Whelan, Carol J., Herrey, Anna S., Gillmore, Julian D., Lachmann, Helen J., Wechalekar, Ashutosh D., Hawkins, Philip N., and Moon, James C.

Published
2015
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21. Systemic Amyloidosis in England: an epidemiological study

Author

Pinney, Jennifer H, Smith, Colette J, Taube, Jessi B, Lachmann, Helen J, Venner, Christopher P, Gibbs, Simon D J, Dungu, Jason, Banypersad, Sanjay M, Wechalekar, Ashutosh D, Whelan, Carol J, Hawkins, Philip N, and Gillmore, Julian D

Subjects
amyloidosis, Adult, Aged, 80 and over, Adolescent, Haematological Malignancy, death certificate, Incidence, Infant, Newborn, Infant, Middle Aged, survival, History, 21st Century, Young Adult, England, Cause of Death, Child, Preschool, Prevalence, Humans, Child, Research Paper, Aged
Abstract

Epidemiological studies of systemic amyloidosis are scarce and the burden of disease in England has not previously been estimated. In 1999, the National Health Service commissioned the National Amyloidosis Centre (NAC) to provide a national clinical service for all patients with amyloidosis. Data for all individuals referred to the NAC is held on a comprehensive central database, and these were compared with English death certificate data for amyloidosis from 2000 to 2008, obtained from the Office of National Statistics. Amyloidosis was stated on death certificates of 2543 individuals, representing 0·58/1000 recorded deaths. During the same period, 1143 amyloidosis patients followed at the NAC died, 903 (79%) of whom had amyloidosis recorded on their death certificates. The estimated minimum incidence of systemic amyloidosis in the English population in 2008, based on new referrals to the NAC, was 0·4/100 000 population. The incidence peaked at age 60-79 years. Systemic AL amyloidosis was the most common type with an estimated minimum incidence of 0·3/100 000 population. Although there are various limitations to this study, the available data suggest the incidence of systemic amyloidosis in England exceeds 0·8/100 000 of the population.

Published
2013

22. T1 mapping and survival in systemic light-chain amyloidosis

Author

Banypersad, Sanjay M., Fontana, Marianna, Maestrini, Viviana, Sado, Daniel M., Captur, Gabriella, Petrie, Aviva, Piechnik, Stefan K., Whelan, Carol J., Herrey, Anna S., Gillmore, Julian D., Lachmann, Helen J., Wechalekar, Ashutosh D., Hawkins, Philip N., and Moon, James C.

Subjects
Heart Failure, Male, Amyloid, Cardiomyopathy, Contrast Media, amyloid, cardiomyopathy, CMR, ECV, heart failure, T1 mapping, amyloidosis, biomarkers, cardiomyopathies, contrast media, female, gadolinium, humans, immunoglobulin light chains, kaplan-meier estimate, magnetic resonance angiography, male, middle aged, prognosis, cardiology and cardiovascular medicine, medicine (all), Gadolinium, Amyloidosis, Kaplan-Meier Estimate, Middle Aged, Prognosis, Imaging, Clinical Research, Humans, Female, Immunoglobulin Light Chains, Cardiomyopathies, Biomarkers, Magnetic Resonance Angiography
Abstract

Aims To assess the prognostic value of myocardial pre-contrast T1 and extracellular volume (ECV) in systemic amyloid light-chain (AL) amyloidosis using cardiovascular magnetic resonance (CMR) T1 mapping. Methods and results One hundred patients underwent CMR and T1 mapping pre- and post-contrast. Myocardial ECV was calculated at contrast equilibrium (ECVi) and 15 min post-bolus (ECVb). Fifty-four healthy volunteers served as controls. Patients were followed up for a median duration of 23 months and survival analyses were performed. Mean ECVi was raised in amyloid (0.44 ± 0.12) as was ECVb (mean 0.44 ± 0.12) compared with healthy volunteers (0.25 ± 0.02), P < 0.001. Native pre-contrast T1 was raised in amyloid (mean 1080 ± 87 ms vs. 954 ± 34 ms, P < 0.001). All three correlated with pre-test probability of cardiac involvement, cardiac biomarkers, and systolic and diastolic dysfunction. During follow-up, 25 deaths occurred. An ECVi of >0.45 carried a hazard ratio (HR) for death of 3.84 [95% confidence interval (CI): 1.53–9.61], P = 0.004 and pre-contrast T1 of >1044 ms = HR 5.39 (95% CI: 1.24–23.4), P = 0.02. Extracellular volume after primed infusion and ECVb performed similarly. Isolated post-contrast T1 was non-predictive. In Cox regression models, ECVi was independently predictive of mortality (HR = 4.41, 95% CI: 1.35–14.4) after adjusting for E:E′, ejection fraction, diastolic dysfunction grade, and NT-proBNP. Conclusion Myocardial ECV (bolus or infusion technique) and pre-contrast T1 are biomarkers for cardiac AL amyloid and they predict mortality in systemic amyloidosis.

Published
2014

23. Response to Letters Regarding Article, “Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis”

Author

Fontana, Marianna, primary, Pica, Silvia, additional, Reant, Patricia, additional, Abdel-Gadir, Amna, additional, Treibel, Thomas A., additional, Banypersad, Sanjay M., additional, Maestrini, Viviana, additional, Barcella, William, additional, Rosmini, Stefania, additional, Bulluck, Heerajnarain, additional, Sayed, Rabya H., additional, Patel, Ketna, additional, Mamhood, Shameem, additional, Bucciarelli-Ducci, Chiara, additional, Whelan, Carol J., additional, Herrey, Anna S., additional, Lachmann, Helen J., additional, Wechalekar, Ashutosh D., additional, Manisty, Charlotte H., additional, Schelbert, Eric B., additional, Kellman, Peter, additional, Gillmore, Julian D., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2016
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24. Differential Myocyte Responses in Patients with Cardiac Transthyretin Amyloidosis and Light-Chain Amyloidosis: A Cardiac MR Imaging Study

Author

Fontana, Marianna, primary, Banypersad, Sanjay M., additional, Treibel, Thomas A., additional, Abdel-Gadir, Amna, additional, Maestrini, Viviana, additional, Lane, Thirusha, additional, Gilbertson, Janet A., additional, Hutt, David F., additional, Lachmann, Helen J., additional, Whelan, Carol J., additional, Wechalekar, Ashutosh D., additional, Herrey, Anna S., additional, Gillmore, Julian D., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2015
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25. Prognostic Value of Late Gadolinium Enhancement Cardiovascular Magnetic Resonance in Cardiac Amyloidosis

Author

Fontana, Marianna, primary, Pica, Silvia, additional, Reant, Patricia, additional, Abdel-Gadir, Amna, additional, Treibel, Thomas A., additional, Banypersad, Sanjay M., additional, Maestrini, Viviana, additional, Barcella, William, additional, Rosmini, Stefania, additional, Bulluck, Heerajnarain, additional, Sayed, Rabya H., additional, Patel, Ketna, additional, Mamhood, Shameem, additional, Bucciarelli-Ducci, Chiara, additional, Whelan, Carol J., additional, Herrey, Anna S., additional, Lachmann, Helen J., additional, Wechalekar, Ashutosh D., additional, Manisty, Charlotte H., additional, Schelbert, Eric B., additional, Kellman, Peter, additional, Gillmore, Julian D., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2015
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26. Extracellular volume quantification in isolated hypertension - changes at the detectable limits?

Author

Treibel, Thomas A., primary, Zemrak, Filip, additional, Sado, Daniel M., additional, Banypersad, Sanjay M., additional, White, Steven K., additional, Maestrini, Viviana, additional, Barison, Andrea, additional, Patel, Vimal, additional, Herrey, Anna S., additional, Davies, Ceri, additional, Caulfield, Mark J., additional, Petersen, Steffen E., additional, and Moon, James C., additional

Published
2015
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27. LGE-PSIR is an independent predictor of mortality in cardiac amyloidosis: a 250 patient prospective study

Author

Fontana, Marianna, primary, Pica, Silvia, additional, Reant, Patricia, additional, Abdel-Gadir, Amna, additional, Treibel, Thomas A, additional, Banypersad, Sanjay M, additional, Maestrini, Viviana, additional, Bulluck, Heerajnarain, additional, Lane, Thirusha L, additional, Lachmann, Helen, additional, Whelan, Carol J, additional, Wechalekar, Ashutosh, additional, Manisty, Charlotte, additional, Herrey, Anna S, additional, Kellman, Peter, additional, Hawkins, Philip N, additional, and Moon, James, additional

Published
2015
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28. Noncontrast myocardial T1 mapping using cardiovascular magnetic resonance for iron overload

Author

Sado, Daniel M., primary, Maestrini, Viviana, additional, Piechnik, Stefan K., additional, Banypersad, Sanjay M., additional, White, Steven K., additional, Flett, Andrew S., additional, Robson, Matthew D., additional, Neubauer, Stefan, additional, Ariti, Cono, additional, Arai, Andrew, additional, Kellman, Peter, additional, Yamamura, Jin, additional, Schoennagel, Bjoern P., additional, Shah, Farrukh, additional, Davis, Bernard, additional, Trompeter, Sara, additional, Walker, Malcolm, additional, Porter, John, additional, and Moon, James C., additional

Published
2014
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29. Native T1 Mapping in Transthyretin Amyloidosis

Author

Fontana, Marianna, primary, Banypersad, Sanjay M., additional, Treibel, Thomas A., additional, Maestrini, Viviana, additional, Sado, Daniel M., additional, White, Steven K., additional, Pica, Silvia, additional, Castelletti, Silvia, additional, Piechnik, Stefan K., additional, Robson, Matthew D., additional, Gilbertson, Janet A., additional, Rowczenio, Dorota, additional, Hutt, David F., additional, Lachmann, Helen J., additional, Wechalekar, Ashutosh D., additional, Whelan, Carol J., additional, Gillmore, Julian D., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2014
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33. Abstract 16829: Myocardial Extracellular Volume Fraction and Survival in Systemic AL Amyloidosis

Author

Banypersad, Sanjay M., primary, Fontana, Marianna, additional, Sado, Daniel M., additional, Pinney, Jennifer H., additional, Mahmood, Shameem, additional, Sachchithanantham, Sajitha, additional, Dungu, Jason, additional, Whelan, Carol J., additional, Wechalekar, Ashutosh D., additional, Gillmore, Julian D., additional, Lachmann, Helen J., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2013
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35. T1 Mapping for Myocardial Extracellular Volume Measurement by CMR

Author

White, Steven K., primary, Sado, Daniel M., additional, Fontana, Marianna, additional, Banypersad, Sanjay M., additional, Maestrini, Viviana, additional, Flett, Andrew S., additional, Piechnik, Stefan K., additional, Robson, Matthew D., additional, Hausenloy, Derek J., additional, Sheikh, Amir M., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2013
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36. Identification and Assessment of Anderson-Fabry Disease by Cardiovascular Magnetic Resonance Noncontrast Myocardial T1 Mapping

Author

Sado, Daniel M., primary, White, Steven K., additional, Piechnik, Stefan K., additional, Banypersad, Sanjay M., additional, Treibel, Thomas, additional, Captur, Gabriella, additional, Fontana, Marianna, additional, Maestrini, Viviana, additional, Flett, Andrew S., additional, Robson, Matthew D., additional, Lachmann, Robin H., additional, Murphy, Elaine, additional, Mehta, Atul, additional, Hughes, Derralynn, additional, Neubauer, Stefan, additional, Elliott, Perry M., additional, and Moon, James C., additional

Published
2013
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37. Noncontrast T1 Mapping for the Diagnosis of Cardiac Amyloidosis

Author

Karamitsos, Theodoros D., primary, Piechnik, Stefan K., additional, Banypersad, Sanjay M., additional, Fontana, Marianna, additional, Ntusi, Ntobeko B., additional, Ferreira, Vanessa M., additional, Whelan, Carol J., additional, Myerson, Saul G., additional, Robson, Matthew D., additional, Hawkins, Philip N., additional, Neubauer, Stefan, additional, and Moon, James C., additional

Published
2013
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38. Senile Systemic Amyloidosis: Clinical Features at Presentation and Outcome

Author

Pinney, Jennifer H., primary, Whelan, Carol J., additional, Petrie, Aviva, additional, Dungu, Jason, additional, Banypersad, Sanjay M., additional, Sattianayagam, Prayman, additional, Wechalekar, Ashutosh, additional, Gibbs, Simon D. J., additional, Venner, Christopher P., additional, Wassef, Nancy, additional, McCarthy, Carolyn A., additional, Gilbertson, Janet A., additional, Rowczenio, Dorota, additional, Hawkins, Philip N., additional, Gillmore, Julian D., additional, and Lachmann, Helen J., additional

Published
2013
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39. Quantification of Myocardial Extracellular Volume Fraction in Systemic AL Amyloidosis

Author

Banypersad, Sanjay M., primary, Sado, Daniel M., additional, Flett, Andrew S., additional, Gibbs, Simon D.J., additional, Pinney, Jennifer H., additional, Maestrini, Viviana, additional, Cox, Andrew T., additional, Fontana, Marianna, additional, Whelan, Carol J., additional, Wechalekar, Ashutosh D., additional, Hawkins, Philip N., additional, and Moon, James C., additional

Published
2013
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41. PATTERNS OF LATE GADOLINIUM ENHANCEMENT PREDICT SURVIVAL IN CARDIAC AMYLOIDOSIS: A SYSTEMATIC REVIEW OF 95 CASES WITH AL OR TTR TYPE

Author

Dungu, Jason, primary, Whelan, Carol J., additional, Gibbs, Simon DJ, additional, Pinney, Jennifer H., additional, Banypersad, Sanjay M., additional, Venner, Christopher P., additional, Lachmann, Helen J., additional, Wechalekar, Ashutosh, additional, Gillmore, Julian D., additional, Hawkins, Philip N., additional, and Anderson, Lisa J., additional

Published
2012
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45. Beyond late gadolinium enhancement: the key role of diffuse myocardial fibrosis in severe aortic stenosis - an Equilibrium Contrast CMR study

Author

Flett, Andrew S, primary, Sado, Dan M, additional, Quarta, Giovanni, additional, Huttin, Olivier, additional, Hausenloy, Derek, additional, Banypersad, Sanjay M, additional, Lawrence, David, additional, Pellerin, Denis, additional, Mcgregor, Christopher, additional, Taylor, Andrew M, additional, and Moon, James C, additional

Published
2011
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47. Noncontrast myocardial T1 mapping using cardiovascular magnetic resonance for iron overload.

Author

Sado, Daniel M., Maestrini, Viviana, Piechnik, Stefan K., Banypersad, Sanjay M., White, Steven K., Flett, Andrew S., Robson, Matthew D., Neubauer, Stefan, Ariti, Cono, Arai, Andrew, Kellman, Peter, Yamamura, Jin, Schoennagel, Bjoern P., Shah, Farrukh, Davis, Bernard, Trompeter, Sara, Walker, Malcolm, Porter, John, and Moon, James C.

Abstract

Purpose To explore the use and reproducibility of magnetic resonance-derived myocardial T1 mapping in patients with iron overload. Materials and Methods The research received ethics committee approval and all patients provided written informed consent. This was a prospective study of 88 patients and 67 healthy volunteers. Thirty-five patients underwent repeat scanning for reproducibility. T1 mapping used the shortened modified Look-Locker inversion recovery sequence (ShMOLLI) with a second, confirmatory MOLLI sequence in the reproducibility group. T2* was performed using a commercially available sequence. The analysis of the T2* interstudy reproducibility data was performed by two different research groups using two different methods. Results Myocardial T1 was lower in patients than healthy volunteers (836 ± 138 msec vs. 968 ± 32 msec, P < 0.0001). Myocardial T1 correlated with T2* (R = 0.79, P < 0.0001). No patient with low T2* had normal T1, but 32% ( n = 28) of cases characterized by a normal T2* had low myocardial T1. Interstudy reproducibility of either T1 sequence was significantly better than T2*, with the results suggesting that the use of T1 in clinical trials could decrease potential sample sizes by 7-fold. Conclusion Myocardial T1 mapping is an alternative method for cardiac iron quantification. T1 mapping shows the potential for improved detection of mild iron loading. The superior reproducibility of T1 has potential implications for clinical trial design and therapeutic monitoring. J. Magn. Reson. Imaging 2015;41:1505-1511. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Published
2015
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48. Diffuse interstitial fibrosis in well-controlled hypertension.

Author

Treibe, Thomas A., Zemrak, Filip, White, Steven K., Sado, Daniel, Banypersad, Sanjay M., Maestrini, Viviana, Caulfield, Mark, Petersen, Steffen E., and Moon, James

Subjects
FIBROSIS, CARDIOVASCULAR disease diagnosis, CONFERENCES & conventions, HYPERTENSION, MAGNETIC resonance imaging, MYOCARDIUM, DIAGNOSIS
Abstract

An abstract of the article "Diffuse interstitial fibrosis in well-controlled hypertension," by Thomas A. Treibe, Filip Zemrak, Steven K. White, Daniel Sado, Sanjay M. Banypersad, Viviana Maestrini, Mark Caufield, Steffen E. Petersen and James Moon is presented.

Published
2013
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