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BRIEFOBSERVATIONPrognosisAssessmentofCardiacInvolvementinSystemicALAmyloidosisbyMagneticResonanceImagingArseneMekinian,MD,aChristopheLions,MD,bXavierLeleu,MD,cAlainDuhamel,MPHD,dNicolasLamblin,MD,eValerieCoiteux,MD,cPascalDeGroote,MD,ePierre-YvesHatron,MD,PhD,aThierryFacon,MD,PhD,cJean-PaulBeregi,MD,PhD,bEricHachulla,MD,PhD,aDavidLaunay,MD,PhDafortheLilleAmyloidosisStudyGroupaServicedeMédecineInterne,HôpitalClaudeHuriez,CentreHospitalierRégionalUniversitaire(CHRU),Lille,France;bServicedeRadiologie,HôpitalCardiologique,CHRU,Lille,France;cServicedesMaladiesduSang,HôpitalClaudeHuriez,CHRU,Lille,France;dCentred’etudesetderecherchéeninformatiquemédicale(CERIM),LaboratoiredeStatistiquesMédicales,FacultédeMédecine,Lille,France;andeServicedeCardiologie,HôpitalCardiologique,CHRU,Lille,France.ABSTRACTBACKGROUND:CardiacinvolvementisoneofthemostimportantprognosticfactorsinsystemicALamyloidosis.Theaimofourstudywastoassesstheroleofcardiovascularmagneticresonance(CMR)imaginginprognosisevaluationinALamyloidosis.METHODS:Weretrospectivelyanalyzed29consecutivepatientswithALamyloidosiswhohadundergoneCMR.Clinical,laboratory,echocardiographic,andCMRcharacteristicswerecomparedbetweenCMR-positive(ie,withCMRsignsofcardiaclocalizationofALamyloidosis)andCMR-negativepatients.UnivariateandmultivariateanalyseswereperformedtoassesstheprognosticvalueofpositiveCMRincomparisonwithotherprognosticfactors.RESULTS:CMRwaspositivein11patients(38%).TheoverallsurvivalratesforCMR-positivepatientswere28%,14%,and14%versus84%,77%,and45%at1,2,and5years,respectively,forCMR-negativepatients(Pϭ.002).Lategadoliniumenhancementpatterns,biventricularhypertrophy,andpericardialeffusiononCMRweremorefrequentinnonsurvivors.Congestiveheartfailure,abnormalechocardiography,EasternCooperativeOncologyGroupgradeϾ1,brainnatriureticpeptide,andleftventricularejectionfractionϽ55%alsowereassociatedwithadecreasedsurvival.Thepresenceofcongestiveheartfailurewastheonlysignificantvariableassociatedwithsurvival
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