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Rapid Fire Abstracts

Rapid Fire 04- Clinical Outcome and Prognosis I

The diagnostic and prognostic value of liver involvement evaluation by 3T MRI T1 mapping in systemic light-chain amyloidosis (RF_TH_264)

Thursday, January 30, 2025
6:20 PM – 6:30 PM East Coast USA Time
Location: Blue Room PreFunction

    Presenting Author(s)

  • KB

    Keying Bi, BMSc

    Ms
    Department of Cardiology, West China Hospital, Sichuan University, China (People's Republic)

    • Primary Author(s)

  • KB

    Keying Bi, BMSc

    Ms
    Department of Cardiology, West China Hospital, Sichuan University, China (People's Republic)

    • Co-Author(s)

  • KW

    Ke Wan, MD

    Dr.
    West China Hospital, China (People's Republic)

  • Yucheng Chen, MD

    Dr.
    West China Hospital, China (People's Republic)

Background: Light chain (AL) amyloidosis is a systemic diasease that affects the heart, kidneys and liver. liver damage in AL amyloidosis is also associated with adverse outcomes. T1 and extracellular volume (ECV) mapping are linked to amyloid burden. However, the relationships between liver T1 mapping and adverse prognosis in AL amyloidosis patients are poorly known. Thus, our aim is to assess the diagnostic and prognostic value of liver T1 and ECV mapping using 3T MRI in AL patients.


Methods: This prospective study included 295 patients with biopsy-proven AL amyloidosis who underwent 3T cardiac MRI between November 2011 to September 2023, with 57 healthy volunteers as normal controls. Liver T1 mapping and ECV were measured on left ventricular short-axis mapping maps. All-cause mortality was defined as the primary endpoint. Significance was set at P < 0.05.


Results:

Liver T1 and ECV were significantly elevated in AL amyloidosis patients with liver involvement compared those without liver involvement (both p</span>＜0.001) and normal controls (both p</span>＜0.001). ROC analysis showed that liver T1 with a cutoff 995ms effectively distinguished AL patients with liver involvement from those without (AUC 0.713, sensitivity 60.5%, specificity 78.3%). Similarly, liver ECV with a cutoff of 42% differentiated AL patients with liver involvement from those without (AUC 0.719, sensitivity 73.7%, specificity 70.0%). Furthermore, during a median follow-up of 41 months, 177 patients (60%) experienced all-cause mortality. Liver ECV independently predicted mortality in AL amyloidosis patients (HR 9.395, CI: 2.892-30.524, p < 0.001), even after adjusting for traditional prognostic factors (HR 4.485, CI: 1.102-18.250, p = 0.036).



Conclusion:

Our study demonstrates that liver T1 and ECV measured by 3T cardiac MRI can identify liver involvement in patients with AL amyloidosis. Additionally, liver ECV can independently predict mortality.