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LGE-CMR, Rahman, J., Helou, E., Gelzer-Bell, R., Thompson, R., Kuo, C., …
LGE-CMR
Results
35 patients with verified CA
97% has abnormal LGE
94% has increased wall thickness
Global transmural or subendocardial most common
LGE-CMR can detect early cardiac abnormalities in patients with amyloidosis
Presence and pattern of LGE
Associated with
Morphological
Functional
Clinical
Biochemical markers
Cardiac Amyloidosis
Infiltration of insoluble deposits
Caused by misfolded fibrillar proteins
Types
Light chains
senile
familial
Thickening of walls and diastolic dysfunction
Leads to restrictive cardiomyopathy
Methods
Study population
2006 to 2007 patients
Total of 120 patients
Inclusion criteria
Proven amyloidosis
Confirmed through monoclonal proteins
Exclusion criteria
Prior stem cell transplant
Prior heart transplant
Prior myocardial infarction
Confirmed CA
Use of endomyocardial biopsy
Cardiac autopsy
Use of cardiovascular magnetic resonance imaging
mass
regional thickness
Ventricular volumes
Ejection fraction
Techniques
Echocardiography
Noninvasive procedure
However, challenging to differentiate
Results are similar to other diseases
Further, existence of left ventricular diseases makes it more problematic
Use of LGE
Late gadolinium enhancement
mechanisms to determine expansions caused byCA
Rahman, J., Helou, E., Gelzer-Bell, R., Thompson, R., Kuo, C.,
Rodriguez, E., Hare, J., Baughman, K., and Kasper, E. Noninvasive
diagnosis of biopsy-proven cardiac amyloidosis. Journal of the American
College of Cardiology 43 (02 2004), 410–5.