Circulation reports · 2026
Regional Myocardial Tissue Characterization by Cardiac Magnetic Resonance Is Associated With Heart Failure Development in Asymptomatic Transthyretin Amyloid Cardiomyopathy.
СтатьяНазвание и аннотация: Перевод в очереди
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Tsuruda Toshihiro, Nakada Hiroshi, Suiko Yosuke, Matsuura Yunosuke, Komaki Soichi, Moribayashi Kohei, Tanaka Hiroki, Yamaguchi Masashi, Yamamoto Kinuko, Ideguchi Takeshi, Ogata Miyuki, Tanaka Miyo, Terada Tamasa, Kawano Masatsugu, Ota Tomomi, Yamashita Atsushi, Yamamoto Keisuke, Nishihira Kensaku, Shibata Yoshisato, Kaikita Koichi
Аннотация
BACKGROUND: Because the number of asymptomatic individuals diagnosed with transthyretin amyloid cardiomyopathy (ATTR-CM) has been rising, it is important to identify myocardial tissue characteristics associated with heart failure (HF) development in asymptomatic patients with ATTR-CM.
METHODS AND RESULTS: Among 113 patients with ATTR-CM, 14 were asymptomatic (mean age 75±6 years; 79% male) and underwent echocardiography and cardiac magnetic resonance imaging (CMR). Over a median follow-up of 770 days, 6 patients developed HF. Compared with those who remained asymptomatic, these patients had a higher left ventricular mass index (LVMI) on echocardiography (P=0.020). On CMR, native T1 was significantly higher at the basal inferior (P=0.0277) and inferolateral (P=0.0017) segments, whereas the extracellular volume (ECV) fraction was significantly higher at the basal inferolateral (P=0.0296) and anterolateral (P=0.0092) segments. LVMI correlated with native T1 (r=0.599, P=0.024) and ECV at the basal inferolateral (r=0.780, P<0.001) and anterolateral (r=0.624, P=0.017) segments. Kaplan-Meier analysis showed that patients with higher LVMI, native T1 at the basal inferolateral segment, and ECV at the basal anterolateral segment had a higher incidence of HF development.
CONCLUSIONS: In asymptomatic ATTR-CM patients, HF development was associated with increased LVMI and regional myocardial tissue abnormalities in the basal lateral wall detected by native T1 and ECV on CMR; however, these findings should be considered exploratory and require validation in larger studies.
METHODS AND RESULTS: Among 113 patients with ATTR-CM, 14 were asymptomatic (mean age 75±6 years; 79% male) and underwent echocardiography and cardiac magnetic resonance imaging (CMR). Over a median follow-up of 770 days, 6 patients developed HF. Compared with those who remained asymptomatic, these patients had a higher left ventricular mass index (LVMI) on echocardiography (P=0.020). On CMR, native T1 was significantly higher at the basal inferior (P=0.0277) and inferolateral (P=0.0017) segments, whereas the extracellular volume (ECV) fraction was significantly higher at the basal inferolateral (P=0.0296) and anterolateral (P=0.0092) segments. LVMI correlated with native T1 (r=0.599, P=0.024) and ECV at the basal inferolateral (r=0.780, P<0.001) and anterolateral (r=0.624, P=0.017) segments. Kaplan-Meier analysis showed that patients with higher LVMI, native T1 at the basal inferolateral segment, and ECV at the basal anterolateral segment had a higher incidence of HF development.
CONCLUSIONS: In asymptomatic ATTR-CM patients, HF development was associated with increased LVMI and regional myocardial tissue abnormalities in the basal lateral wall detected by native T1 and ECV on CMR; however, these findings should be considered exploratory and require validation in larger studies.