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Clinical value of CMR left ventricular long-axis strain in predicting LGE in cardiac amyloidosis secondary to multiple myeloma
HU Mengyao  SONG Yipei  ZHENG Tian  YU Sisi  LI Shuhao  TAO Xinwei  GONG Lianggeng 

Cite this article as: Hu MY, Song YP, Zheng T, et al. Clinical value of CMR left ventricular long-axis strain in predicting LGE in cardiac amyloidosis secondary to multiple myeloma[J]. Chin J Magn Reson Imaging, 2022, 13(12): 26-31, 44. DOI:10.12015/issn.1674-8034.2022.12.005.


[Abstract] Objective To investigate the predictive value of left ventricular long-axis strain (LV LAS) with cardiac magnetic resonance (CMR) in patients with cardiac amyloidosis secondary to multiple myeloma (MM) with late gadolinium enhancement (LGE).Materials and Methods The clinical data and CMR parameters of 33 patients with CA secondary to MM and 29 control groups were retrospectively analyzed. CA patients secondary to MM were divided into LGE (+) group and LGE (-) group according to the presence or absence of abnormal enhancement, univariate logistic regression and receiver operating characteristic (ROC) curve was used to analyze the predictive value of CMR parameters for LGE in CA patients secondary to MM. The intra-class correlation coefficient (ICC) test was used to analyze the differences between and within observers of the left ventricular long axis strain (LV LAS) of CMR.Results Most patients with CA secondary to MM are elderly men (accounting for 72.7%), with complex clinical symptoms and abnormal results such as electrocardiograms. Compared with the LGE (-) group, patients with LGE (+) had lower left ventricular ejection fraction (LVEF), cardiac index (CI), greater left ventricular mass index (LVMI), and more severe LV LAS damage (P＜0.05). Univariate logistic regression analysis showed that there were statistically significant differences in the prediction of LGE positivity by LVEF, CI, LVMI and LV LAS (P＜0.05). ROC analysis showed that LV LAS＜-14.3% [area under the curve (AUC): 0.909, sensitivity: 90.5%, specificity: 75.0%, 95% CI: 0.756-0.981] and LVMI＞83.9 g/m² (AUC: 0.877, sensitivity: 71.4%, specificity: 100.0%, 95% CI: 0.716-0.965) predicted good LGE positive efficacy in CA patients.Conclusions LV LAS can not only quantitatively assess the severity impaired of left ventricular function in CA patients secondary to MM, but also has predictive value for LGE. It can provide decision-making for early clinical quantitative assessment of cardiac involvement and prevention of serious adverse events in patients with renal insufficiency.
[Keywords] multiple myeloma；cardiac amyloidosis；left ventricle；long-axis strain；cardiac magnetic resonance；magnetic resonance imaging；late gadolinium enhancement

HU Mengyao1   SONG Yipei1   ZHENG Tian1   YU Sisi1   LI Shuhao1   TAO Xinwei2   GONG Lianggeng1*  

1 Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China

2 Department of Imaging Diagnosis, Bayer HealthCare, Beijing 100176, China

Gong LG, E-mail: gong111999@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 81860316); Natural Science Foundation of Jiangxi Province (No. 20212ACB206021).
Received  2022-08-08
Accepted  2022-11-29
DOI: 10.12015/issn.1674-8034.2022.12.005
Cite this article as: Hu MY, Song YP, Zheng T, et al. Clinical value of CMR left ventricular long-axis strain in predicting LGE in cardiac amyloidosis secondary to multiple myeloma[J]. Chin J Magn Reson Imaging, 2022, 13(12): 26-31, 44. DOI:10.12015/issn.1674-8034.2022.12.005.

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