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1、BRIEFOBSERVATIONPrognosisAssessmentofCardiacInvolvementinSystemicALAmyloidosisbyMagneticResonanceImagingabcdeArseneMekinian,MD,ChristopheLions,MD,XavierLeleu,MD,AlainDuhamel,MPHD,NicolasLamblin,MD,ceacValerieCoiteux,MD,PascalDeGroote,MD,Pierre-YvesHatron,MD,PhD,ThierryFacon,MD,P
2、hD,baaJean-PaulBeregi,MD,PhD,EricHachulla,MD,PhD,DavidLaunay,MD,PhDfortheLilleAmyloidosisStudyGroupabServicedeMédecineInterne,HôpitalClaudeHuriez,CentreHospitalierRégionalUniversitaire(CHRU),Lille,France;ServicedecRadiologie,HôpitalCardiologique,CHRU,Lille,France;ServicedesMalad
3、iesduSang,HôpitalClaudeHuriez,CHRU,Lille,dFrance;Centred’etudesetderecherchéeninformatiquemédicale(CERIM),LaboratoiredeStatistiquesMédicales,FacultédeeMédecine,Lille,France;andServicedeCardiologie,HôpitalCardiologique,CHRU,Lille,France.ABSTRACTBACKGROUND:Cardiacinvolvementisoneo
4、fthemostimportantprognosticfactorsinsystemicALamyloidosis.Theaimofourstudywastoassesstheroleofcardiovascularmagneticresonance(CMR)imaginginprognosisevaluationinALamyloidosis.METHODS:Weretrospectivelyanalyzed29consecutivepatientswithALamyloidosiswhohadundergoneCMR.Clinical,labora
5、tory,echocardiographic,andCMRcharacteristicswerecomparedbetweenCMR-positive(ie,withCMRsignsofcardiaclocalizationofALamyloidosis)andCMR-negativepatients.UnivariateandmultivariateanalyseswereperformedtoassesstheprognosticvalueofpositiveCMRincomparisonwithotherprognosticfactors.RES
6、ULTS:CMRwaspositivein11patients(38%).TheoverallsurvivalratesforCMR-positivepatientswere28%,14%,and14%versus84%,77%,and45%at1,2,and5years,respectively,forCMR-negativepatients(P.002).Lategadoliniumenhancementpatterns,biventricularhypertrophy,andpericardialeffusiononCMRweremorefre
7、quentinnonsurvivors.Congestiveheartfailure,abnormalechocardiography,EasternCooperativeOncologyGroupgrade1,brainnatriureticpeptide,andleftventricularejectionfraction55%alsowereassociatedwithadecreasedsurvival.Thepresenceofcongestiveheartfailurewastheonlysignificantvariableassoci
8、atedwithsurvivalonmultivariateanalysis.CONCLUSI
