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.

التفاصيل البيبلوغرافية
العنوان:	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.
المؤلفون:	Datar, Yesh, Clerc, Olivier F, Cuddy, Sarah A M, Kim, Sirwoo, Taylor, Alexandra, Neri, Jocelyn Canseco, Benz, Dominik C, Bianchi, Giada, Yee, Andrew J, Sanchorawala, Vaishali, Ruberg, Frederick L, Landau, Heather, Liao, Ronglih, Kijewski, Marie Foley, Jerosch-Herold, Michael, Kwong, Raymond Y, Carli, Marcelo F Di, Falk, Rodney H, Dorbala, Sharmila
المصدر:	European Heart Journal - Cardiovascular Imaging; May2024, Vol. 25 Issue 5, p687-697, 11p
مصطلحات موضوعية:	CARDIAC amyloidosis, IMMUNOGLOBULIN light chains, CARDIOMYOPATHIES, RESEARCH funding, COMPUTED tomography, TREATMENT effectiveness, DESCRIPTIVE statistics, PEPTIDE hormones, MULTIVARIATE analysis, AMYLOIDOSIS, LUNGS, LONGITUDINAL method, RIGHT ventricular dysfunction, EMISSION-computed tomography, RIGHT heart ventricle, ECHOCARDIOGRAPHY, EVALUATION
مستخلص:	Aims In systemic light-chain (AL) amyloidosis, quantification of right ventricular (RV) amyloid burden has been limited and the pathogenesis of RV dysfunction is poorly understood. Using ¹⁸F-florbetapir positron emission tomography/computed tomography (PET/CT), we aimed to quantify RV amyloid; correlate RV amyloid with RV structure and function; determine the independent contributions of RV, left ventricular (LV), and lung amyloid to RV function; and associate RV amyloid with major adverse cardiac events (MACE: death, heart failure hospitalization, cardiac transplantation). Methods and results We prospectively enrolled 106 participants with AL amyloidosis (median age 62 years, 55% males) who underwent ¹⁸F-florbetapir PET/CT, magnetic resonance imaging, and echocardiography. ¹⁸F-florbetapir PET/CT identified RV amyloid in 63% of those with and 40% of those without cardiac involvement by conventional criteria. RV amyloid burden correlated with RV ejection fraction (EF), RV free wall longitudinal strain (FWLS), RV wall thickness, RV mass index, N-terminal pro-brain natriuretic peptide, troponin T, LV amyloid, and lung amyloid (each P < 0.001). In multivariable analysis, RV amyloid burden, but not LV or lung amyloid burden, predicted RV dysfunction (EF P = 0.014; FWLS P < 0.001). During a median follow-up of 28 months, RV amyloid burden predicted MACE (P < 0.001). 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. These results imply a central role for RV amyloid in the pathogenesis of RV dysfunction. [ABSTRACT FROM AUTHOR]
	Copyright of European Heart Journal - Cardiovascular Imaging is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
قاعدة البيانات:	Complementary Index

Full Text Finder

الوصف
تدمد:	20472404
DOI:	10.1093/ehjci/jead350