The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment?
PurposeAmyloid overload and microcirculation impairment are both detrimental to left ventricular (LV) systolic function, while it is not clear which factor dominates LV functional remodeling in patients with cardiac amyloidosis (CA). The purpose of this study was to investigate the major factor of L...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1096130/full |
| _version_ | 1797942729619013632 |
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| author | Jianyao Lu Peijun Zhao Peijun Zhao Jinhan Qiao Zhaoxia Yang Dazhong Tang Xiaoyue Zhou Lu Huang Liming Xia |
| author_facet | Jianyao Lu Peijun Zhao Peijun Zhao Jinhan Qiao Zhaoxia Yang Dazhong Tang Xiaoyue Zhou Lu Huang Liming Xia |
| author_sort | Jianyao Lu |
| collection | DOAJ |
| description | PurposeAmyloid overload and microcirculation impairment are both detrimental to left ventricular (LV) systolic function, while it is not clear which factor dominates LV functional remodeling in patients with cardiac amyloidosis (CA). The purpose of this study was to investigate the major factor of LV systolic dysfunction using cardiac magnetic resonance imaging.Materials and methodsForty CA patients and 20 healthy controls were included in this study. The CA group was divided into two subgroups by the left ventricular ejection fraction (LVEF): patients with reduced LVEF (LVEF < 50%, rLVEF), and patients with preserved LVEF (LVEF ≥ 50%, pLVEF). The scanning sequences included cine, native and post-contrast T1 mapping, rest first-pass perfusion and late gadolinium enhancement. Perfusion and mapping parameters were compared among the three groups. Correlation analysis was performed to evaluate the relationship between LVEF and mapping parameters, as well as the relationship between LVEF and perfusion parameters.ResultsRemarkably higher native T1 value was observed in the rLVEF patients than the pLVEF patients (1442.2 ± 85.8 ms vs. 1407.0 ± 93.9 ms, adjusted p = 0.001). The pLVEF patients showed significantly lower slope dividing baseline signal intensity (slope%BL; rLVEF vs. pLVEF, 55.1 ± 31.0 vs. 46.2 ± 22.3, adjusted p = 0.001) and a lower maximal signal intensity subtracting baseline signal intensity (MaxSI-BL; rLVEF vs. pLVEF, 43.5 ± 23.9 vs. 37.0 ± 18.6, adjusted p = 0.003) compared to the rLVEF patients. CA patients required more time to reach the maximal signal intensity than the controls did (all adjusted p < 0.01). There was no significant correlation between LVEF and first-pass perfusion parameters, while significant negative correlation was observed between LVEF and native T1 (r = −0.434, p = 0.005) in CA patients.ConclusionAmyloid overload in the myocardial interstitium may be the major factor of LV systolic dysfunction in CA patients, other than microcirculation impairment. |
| first_indexed | 2024-04-10T20:12:27Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-10T20:12:27Z |
| publishDate | 2023-01-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7f8ae88d92f74406b3f4d22c8a0f972d2023-01-26T09:47:26ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-01-011010.3389/fcvm.2023.10961301096130The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment?Jianyao Lu0Peijun Zhao1Peijun Zhao2Jinhan Qiao3Zhaoxia Yang4Dazhong Tang5Xiaoyue Zhou6Lu Huang7Liming Xia8Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaThe Department of MRI, First Affiliated Hospital of Xiamen University, Xiamen, ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaMR Collaboration, Siemens Healthineers Ltd., Shanghai, ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaPurposeAmyloid overload and microcirculation impairment are both detrimental to left ventricular (LV) systolic function, while it is not clear which factor dominates LV functional remodeling in patients with cardiac amyloidosis (CA). The purpose of this study was to investigate the major factor of LV systolic dysfunction using cardiac magnetic resonance imaging.Materials and methodsForty CA patients and 20 healthy controls were included in this study. The CA group was divided into two subgroups by the left ventricular ejection fraction (LVEF): patients with reduced LVEF (LVEF < 50%, rLVEF), and patients with preserved LVEF (LVEF ≥ 50%, pLVEF). The scanning sequences included cine, native and post-contrast T1 mapping, rest first-pass perfusion and late gadolinium enhancement. Perfusion and mapping parameters were compared among the three groups. Correlation analysis was performed to evaluate the relationship between LVEF and mapping parameters, as well as the relationship between LVEF and perfusion parameters.ResultsRemarkably higher native T1 value was observed in the rLVEF patients than the pLVEF patients (1442.2 ± 85.8 ms vs. 1407.0 ± 93.9 ms, adjusted p = 0.001). The pLVEF patients showed significantly lower slope dividing baseline signal intensity (slope%BL; rLVEF vs. pLVEF, 55.1 ± 31.0 vs. 46.2 ± 22.3, adjusted p = 0.001) and a lower maximal signal intensity subtracting baseline signal intensity (MaxSI-BL; rLVEF vs. pLVEF, 43.5 ± 23.9 vs. 37.0 ± 18.6, adjusted p = 0.003) compared to the rLVEF patients. CA patients required more time to reach the maximal signal intensity than the controls did (all adjusted p < 0.01). There was no significant correlation between LVEF and first-pass perfusion parameters, while significant negative correlation was observed between LVEF and native T1 (r = −0.434, p = 0.005) in CA patients.ConclusionAmyloid overload in the myocardial interstitium may be the major factor of LV systolic dysfunction in CA patients, other than microcirculation impairment.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1096130/fullcardiac amyloidosismagnetic resonance imagingleft ventricular systolic dysfunctionamyloid overloadmicrocirculation impairment |
| spellingShingle | Jianyao Lu Peijun Zhao Peijun Zhao Jinhan Qiao Zhaoxia Yang Dazhong Tang Xiaoyue Zhou Lu Huang Liming Xia The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment? Frontiers in Cardiovascular Medicine cardiac amyloidosis magnetic resonance imaging left ventricular systolic dysfunction amyloid overload microcirculation impairment |
| title | The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment? |
| title_full | The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment? |
| title_fullStr | The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment? |
| title_full_unstemmed | The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment? |
| title_short | The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment? |
| title_sort | major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis amyloid overload or microcirculation impairment |
| topic | cardiac amyloidosis magnetic resonance imaging left ventricular systolic dysfunction amyloid overload microcirculation impairment |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1096130/full |
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