title: Prognostic impact of T2-weighted CMR imaging for cardiac amyloidosis.
abstract: OBJECTIVE
  Using cardiac magnetic resonance imaging (MRI) we tested the diagnostic value of various markers for amyloid infiltration.
  
  
  METHODS
  We performed MRI at 1.5 T in 36 consecutive patients with cardiac amyloidosis and 48 healthy volunteers. The protocol included cine imaging, T2-weighted spin echo, T1-weighted spin echo before and early after contrast and late gadolinium enhancement. We compared the frequency of abnormalities and their relation to mortality.
  
  
  RESULTS
  Median follow-up was 31 months. Twenty-three patients died. Mean left ventricular (LV) mass was 205 ± 70 g. LV ejection fraction (EF) was 55 ± 12%. T2 ratio was 1.5 ± 0.4. 33/36 patients had pericardial and 22/36 had pleural effusions. All but two had heterogeneous late enhancement. Surviving patients did not differ from those who had died with regard to gender, LV mass or volume. Surviving patients had a significantly higher LVEF (60.4 ± 9.9% vs. 51.6 ± 11.5%; p = 0.03). The deceased patients had a lower T2 ratio than those who survived (1.38 ± 0.42 vs. 1.76 ± 0.17; p = 0.005). Low T2 was associated with shorter survival (Chi-squared 11.3; p < 0.001). Cox regression analysis confirmed T2 ratio < 1.5 as the only independent predictors for survival.
  
  
  CONCLUSIONS
  Cardiac amyloidosis is associated with hypointense signal on T2-weighted images. A lower T2 ratio was independently associated with shortened survival.
authors: HELIOS Klinikum Berlin Buch & Charite Campus Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany. ralf.wassmuth@charite.de
authors: Ralf
authors: R
authors: Wassmuth
authors: Hassan
authors: H
authors: Abdel-Aty
authors: Steffen
authors: S
authors: Bohl
authors: Jeanette
authors: J
authors: Schulz-Menger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000473:pathology*; D001706:Biopsy; D016022:Case-Control Studies; D003287:Contrast Media; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D006331:Heart Diseases / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA