Abstract 14525: Cardiac Magnetic Resonance Elastography as a Quantitative Non-Invasive Metric for Myocardial Stiffness: Initial Pilot Study in Patients With Cardiac Amyloidosis
Introduction: The biomechanical properties of myocardial tissue play an important role in cardiac function. Specifically in cardiac amyloidosis there is evidence that abnormal protein fibrils build up in the myocardium leading to firm, waxy and rubbery tissue composition at autopsy. Thus, a non-invasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. Our group has recently developed a high frequency cardiac magnetic resonance elastography (MRE) technique capable of making non-invasive stiffness measurements in vivo, but its clinical application has not been evaluated in a patient population. The objective of this abstract is to evaluate if cardiac MRE can measure increased stiffness in patients with cardiac amyloidosis.
Methods: Sixteen volunteers and 22 patients with amyloidosis were enrolled in this study, after IRB approval and obtaining formal written consent. Five volunteers and 6 patients had to be excluded from the study due to poor image quality as determined by a quantitative octahedral shear strain signal-to-noise ratio metric. All subjects were imaged head first in the supine position in a 1.5-Tesla closed-bore MR imager (Optima MR450W; GE Healthcare, Milwaukee, WI, USA). MRE was performed using 5 mm isotropic resolution oblique short-axis slices and a vibration frequency of 140Hz.
Results and Conclusions: The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (p = 0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8). Sample stiffness maps are shown in Figure 1. This study demonstrates the feasibility of high-frequency cardiac MRE as a contrast-agent-free diagnostic imaging technique for cardiac amyloidosis.
Author Disclosures: A. Arani: None. S.P. Arunachalam: None. I.C. Chang: None. F. Baffour: None. P.J. Rossman: Ownership Interest; Modest; Resoundant Inc. K. Glaser: Ownership Interest; Modest; Resoundant Inc.. J.D. Trzasko: None. A. Manduca: Ownership Interest; Modest; Resoundant Inc. K.P. McGee: Ownership Interest; Modest; Resoundant Inc.. M. Grogan: None. A. Dispenzieri: None. R.L. Ehman: Research Grant; Significant; Resoundant Inc.. Ownership Interest; Significant; Resoundant Inc.. P.A. Araoz: None.
- © 2016 by American Heart Association, Inc.