Comparison of tissue tracking assessment by cardiovascular magnetic resonance for cardiac amyloidosis and hypertrophic cardiomyopathy

Abstract

Background

Administration of gadolinium-contrast can cause problems in cardiac amyloidosis (CA) patients with impaired renal function.

Purpose

To compare patterns of cardiovascular magnetic resonance tissue tracking (CMR-TT) for CA and hypertrophic cardiomyopathy (HCM) and to assess the feasibility of CMR-TT to distinguish between these diseases without administration of gadolinium-contrast.

Material and Methods

Included were 54 patients with biopsy-proven CA, 40 patients with HCM, and 30 healthy people. We calculated strain ratio of apex to base (SRAB) in the left ventricle (LV) using radial (R), circumferential (C), and longitudinal (L) strain from CMR-TT. The LV ejection fraction (LVEF) and the ratio of septal to posterior wall at basal level were also calculated. Late gadolinium enhancement (LGE) image analysis was performed for differential diagnosis. Area under the receiver operating characteristic curve (AUC) comparisons were used.

Results

All SRAB values were significantly different between CA and HCM (all P < 0.001). AUC values for parameters were 0.806 for LVEF, 0.815 for ratio of wall thickness, 0.944 for the LGE pattern, 0.898 for SRAB_R, 0.880 for SRAB_C, and 0.805 for SRAB_L. AUCs for the LGE pattern were significantly higher than for LVEF, ratio of wall thickness and SRAB_L (all P < 0.008). No significant differences were seen between AUCs for the LGE pattern, SRAB_R, and SRAB_C (all P > 0.109).

Conclusion

SRAB_R and SRAB_C were reliable parameters for distinguishing between CA and HCM.

Keywords

Tissue tracking cardiovascular magnetic resonance cardiac amyloidosis hypertrophic cardiomyopathy strain myocardial strain

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References

Patel

Hawkins

PN.

Cardiac amyloidosis: where are we today?

J Intern Med 2015; 278:126–144.

Zhao

Tian

Fang

Diagnostic accuracy of cardiovascular magnetic resonance for patients with suspected cardiac amyloidosis: a systematic review and meta-analysis.

BMC Cardiovasc Disord 2016; 16:129.

Falk

Comenzo

Skinner

The systemic amyloidoses.

N Engl J Med 1997; 337:898–909.

Maceira

Joshi

Prasad

, et al. Cardiovascular magnetic resonance in cardiac amyloidosis. Circulation 2005; 111:186–193.

Edelman

RR.

Contrast-enhanced MR imaging of the heart: overview of the literature.

Radiology 2004; 232:653–668.

Sun

Stewart

Yang

, et al. Differentiation of hypertrophic cardiomyopathy and cardiac amyloidosis from other causes of ventricular wall thickening by two-dimensional strain imaging echocardiography. Am J Cardiol 2009; 103:411–415.

Baccouche

Maunz

Beck

, et al. Differentiating cardiac amyloidosis and hypertrophic cardiomyopathy by use of three-dimensional speckle tracking echocardiography. Echocardiography 2012; 29:668–677.

Phelan

Collier

Thavendiranathan

, et al. Relative apical sparing of longitudinal strain using two-dimensional speckle-tracking echocardiography is both sensitive and specific for the diagnosis of cardiac amyloidosis. Heart 2012; 98:1442–1448.

Liu

Niemann

, et al. Effect of combined systolic and diastolic functional parameter assessment for differentiation of cardiac amyloidosis from other causes of concentric left ventricular hypertrophy. Circ Cardiovasc Imaging 2013; 6:1066–1072.

10.

Williams

Forero

Popovic

, et al. Patterns of CMR measured longitudinal strain and its association with late gadolinium enhancement in patients with cardiac amyloidosis and its mimics. J Cardiovasc Magn Reson 2017; 19:61.

11.

Pandey

Alapati

Wadhwa

, et al. Evaluation of myocardial strain in patients with amyloidosis using cardiac magnetic resonance feature tracking. Curr Probl Diagn Radiol 2017; 46:288–294.

12.

Bhatti

Vallurupalli

Ambach

, et al. Myocardial strain pattern in patients with cardiac amyloidosis secondary to multiple myeloma: a cardiac MRI feature tracking study. Int J Cardiovasc Imaging 2018; 34:27–33.

13.

Kuruvilla

Janardhanan

Antkowiak

, et al. Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone. JACC Cardiovasc Imaging 2015; 8:172–180.

14.

Gersh

Maron

Bonow

, et al. 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 124:2761–2796.

15.

Maron

BJ.

Hypertrophic cardiomyopathy: A systematic review.

JAMA 2002; 287:1308–1320.

16.

Kansal

Roitman

Sheffield

LT.

Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.

Circulation 1979; 60:1058–1065.

17.

Syed

Glockner

Feng

, et al. Role of cardiac magnetic resonance imaging in the detection of cardiac amyloidosis. JACC Cardiovasc Imaging 2010; 3:155–164.

18.

Liu

Zhang

Yang

, et al. Assessment of left ventricular deformation in patients with Ebstein’s anomaly by cardiac magnetic resonance tissue tracking. Eur J Radiol 2017; 89:20–26.

19.

Cerqueira

Weissman

Dilsizian

, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 2002; 105:539–542.

20.

Liu

Leal

, et al. Measurement of myocardial native T1 in cardiovascular diseases and norm in 1291 subjects. J Cardiovasc Magn Reson 2017; 19:74.

21.

Nam

Kim

Jung

, et al. Comparison of quantitative imaging parameters using cardiovascular magnetic resonance between cardiac amyloidosis and hypertrophic cardiomyopathy: inversion time scout versus T1 mapping. Int J Cardiovasc Imaging 2018; 34:1769–1777.

22.

Martinez-Naharro

Kotecha

Norrington

, et al. Native T1 and extracellular volume in transthyretin amyloidosis. JACC Cardiovasc Imaging 2019; 12:810–819.

23.

Robin

Turck

Hainard

, et al. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 2011; 12:77.

24.

Youden

WJ.

Index for rating diagnostic tests.

Cancer 1950; 3:32–35.

25.

Noureldin

Liu

Nacif

, et al. The diagnosis of hypertrophic cardiomyopathy by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012; 14:17.

26.

Belkin

Kupersmith

Khalique

, et al. A novel two-dimensional echocardiographic finding in cardiac amyloidosis. Echocardiography 2010; 27:1171–1176.

27.

Bissell

Hall

Parry

How does the extracellular matrix direct gene expression?

J Theor Biol 1982; 99:31–68.

28.

Biering-Sorensen

Olsen

, et al. Global longitudinal strain by echocardiography predicts long-term risk of cardiovascular morbidity and mortality in a low-risk general population: The Copenhagen City Heart Study. Circ Cardiovasc Imaging 2017; 10:e005521.

29.

Gunasekaran

Panaich

Briasoulis

, et al. Incremental value of two dimensional speckle tracking echocardiography in the functional assessment and characterization of subclinical left ventricular dysfunction. Curr Cardiol Rev 2017; 13:32–40.

30.

Oda

Utsunomiya

Nakaura

, et al. Identification and assessment of cardiac amyloidosis by myocardial strain analysis of cardiac magnetic resonance imaging. Circ J 2017; 81:1014–1021.

31.

Schulz-Menger

Bluemke

Bremerich

, et al. Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post Processing. J Cardiovasc Magn Reason 2013; 15:35.

32.

Swoboda

McDiarmid

Erhayiem

, et al. Effect of cellular and extracellular pathology assessed by T1 mapping on regional contractile function in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 2017; 19:16.

33.

de Marvao

Dawes

Shi

, et al. Population-based studies of myocardial hypertrophy: high resolution cardiovascular magnetic resonance atlases improve statistical power. J Cardiovasc Magn Reason 2014;16: 16.

34.

Tarkiainen

Sipola

Jalanko

, et al. Cardiovascular magnetic resonance of mitral valve length in hypertrophic cardiomyopathy. J Cardiovasc Magn Reason 2016; 18:33.

35.

Zhu

Park

Lee

, et al. Extent of late gadolinium enhancement at right ventricular insertion points in patients with hypertrophic cardiomyopathy: relation with diastolic dysfunction. Eur Radiol 2015; 25:1190–1200.

36.

Barreiro-Perez

Curione

Symons

, et al. Left ventricular global myocardial strain assessment comparing the reproducibility of four commercially available CMR-feature tracking algorithms. Eur Radiol 2018; 28:5137–5147.

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