Title |
Increased Prognostic Value of Query Amyloid Late Enhancement Score in Light-Chain Cardiac Amyloidosis
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Published in |
Circulation Journal, November 2017
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DOI | 10.1253/circj.cj-17-0464 |
Pubmed ID | |
Authors |
Ke Wan, Jiayu Sun, Yuchi Han, Hong Liu, Dan Yang, Weihao Li, Jie Wang, Wei Cheng, Qing Zhang, Zhi Zeng, Yucheng Chen |
Abstract |
Late gadolinium enhancement (LGE) pattern is a powerful imaging biomarker for prognosis of cardiac amyloidosis. It is unknown if the query amyloid late enhancement (QALE) score in light-chain (AL) amyloidosis could provide increased prognostic value compared with LGE pattern.Methods and Results:Seventy-eight consecutive patients with AL amyloidosis underwent contrast-enhanced cardiovascular magnetic resonance imaging. Patients with cardiac involvement were grouped by LGE pattern and analyzed using QALE score. Receiver operating characteristic curve was used to identify the optimal cut-off for QALE score in predicting all-cause mortality. Survival of these patients was analyzed with the Kaplan-Meier method and multivariate Cox regression. During a median follow-up of 34 months, 53 of 78 patients died. The optimal cut-off for QALE score to predict mortality at 12-month follow-up was 9.0. On multivariate Cox analysis, QALE score ≥9 (HR, 5.997; 95% CI: 2.665-13.497; P<0.001) and log N-terminal pro-brain natriuretic peptide (HR, 1.525; 95% CI: 1.112-2.092; P=0.009) were the only 2 independent predictors of all-cause mortality. On Kaplan-Meier analysis, patients with subendocardial LGE can be further risk stratified using QALE score ≥9. The QALE scoring system provides powerful independent prognostic value in AL cardiac amyloidosis. QALE score ≥9 has added value to differentiate prognosis in AL amyloidosis patients with a subendocardial LGE pattern. |
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United Kingdom | 1 | 33% |
United States | 1 | 33% |
Unknown | 1 | 33% |
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Scientists | 1 | 33% |
Mendeley readers
Geographical breakdown
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Unknown | 16 | 100% |
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Student > Master | 3 | 19% |
Researcher | 2 | 13% |
Student > Ph. D. Student | 2 | 13% |
Student > Doctoral Student | 1 | 6% |
Student > Bachelor | 1 | 6% |
Other | 3 | 19% |
Unknown | 4 | 25% |
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Economics, Econometrics and Finance | 1 | 6% |
Biochemistry, Genetics and Molecular Biology | 1 | 6% |
Social Sciences | 1 | 6% |
Neuroscience | 1 | 6% |
Other | 0 | 0% |
Unknown | 6 | 38% |