Pre-contrast ShMOLLI T1 mapping in cardiac AL amyloidosis
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Pre-contrast ShMOLLI T1 mapping in cardiac AL amyloidosis Theodoros Karamitsos2*, Sanjay M Banypersad1,3, Daniel Sado1, Viviana Maestrini1, Vanessa Ferreira2, Stefan K Piechnik2, Matthew D Robson2, Philip N Hawkins3, Stefan Neubauer2, James Moon1 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Background Multi-organ disease with cardiac involvement carries a very poor prognosis in Systemic AL Amyloidosis. The risk of nephrogenic systemic fibrosis is a significant obstacle in assessing cardiac status using CMR in patients with systemic AL amyloidosis who have advanced renal failure. Measurement of myocardial T1 values has been limited until now, due to long breathhold times. We have developed a robust and clinically applicable technique for diagnosing cardiac amyloidosis by measuring absolute myocardial T1 values using the single breath hold, Shortened Modified Look-Locker Inversion Recovery (ShMOLLI) sequence without gadolinium administration. Methods Thirty-five patients (23 males, 12 females, mean age 60 years) with systemic AL amyloidosis underwent conventional CMR scanning with cine imaging and late gadolinium imaging as well as ShMOLLI pre-contrast T1mapping between both centres; all patients had an eGFR of >30ml/min. Myocardial T1 values from the basal septum in the apical 4-chamber view were measured and compared against cardiac biomarkers, and ECG data. Results were compared to normal controls (n=54). Conventional clinical assessment using the Mayo staging system ranked cardiac involvement as definite, probable and none.
probability of cardiac involvement based on clinical evaluation, myocardial T1 in patients with probable and definite cardiac disease was significantly higher than normals (P
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