[Value of cardiac magnetic resonance imaging for the diagnosis of cardiac amyloidosis].
OBJECTIVE
To observe the clinical features and cardiac magnetic resonance imaging (CMR) characteristics of patients with endomyocardial biopsy (EMB)-proven cardiac amyloidosis (CA).


METHODS
EMB proven CA patients underwent CMR examination from September 2006 to December 2010 were included. The findings of clinical manifestation, electrocardiogram, echocardiography and CMR were analyzed.


RESULTS
Among the 18 patients with EMB verified CA, 5 patients underwent CMR. All 5 patients had heart failure symptoms and electrocardiogram was abnormal. Echocardiogram showed concentric left ventricular hypertrophy, granular appearance of the myocardium, left atrial enlargement and moderate to severe left ventricular diastolic dysfunction. CMR revealed increased thickness of the left ventricular wall (especially at the inter-ventricular septum), enlarged bilateral auricle, restricted left ventricular filling with normal or mild to moderate reduced systolic function. Pleural and pericardial effusions were observed in 2 patients. Abnormal late gadolinium enhancement (LGE) was detected in all 5 patients. CMR revealed different patterns of LGE. Left ventricular global subendocardial delayed gadolinium enhancement or transmural delayed gadolinium enhancement were found, and patients also showed line-, granular- or patchy-like enhancement. The degree and range of LGE paralleled the disease course and were consistent with electrocardiogram changes.


CONCLUSIONS
As a noninvasive diagnostic tool, CMR is valuable in the diagnosis of CA. For patients with clinical suspicion of CA, CMR could be a helpful diagnostic tool, especially in the hospitals where EMB is not available.
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Kong-bo
KB
Zhu
Zhong-wei
ZW
Cheng
Zhuang
Z
Tian
Da-chun
DC
Zhao
Yong-tai
YT
Liu
Xue
X
Lin
Tai-bo
TB
Chen
Hong-zhi
HZ
Xie
Yong
Y
Zeng
Li-gang
LG
Fang
Xiu-chun
XC
Jiang
Quan-cai
QC
Cui
Quan
Q
Fang
D000686:Amyloidosis / Q000175:diagnosis*; D001706:Biopsy; D009202:Cardiomyopathies / Q000175:diagnosis*; D004452:Echocardiography; D004562:Electrocardiography; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D017379:Hypertrophy, Left Ventricular; D008279:Magnetic Resonance Imaging; D009206:Myocardium; D013599:Systole
D005682:Gadolinium; D019786:Gadolinium DTPA