دورية أكاديمية
Prognostic Value of Left Ventricular 18 F-Florbetapir Uptake in Systemic Light-Chain Amyloidosis.
| العنوان: | Prognostic Value of Left Ventricular 18 F-Florbetapir Uptake in Systemic Light-Chain Amyloidosis. |
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| المؤلفون: | Clerc OF; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Datar Y; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Cuddy SAM; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; CV Imaging Program, Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Bianchi G; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Taylor A; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Benz DC; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Robertson M; CV Imaging Program, Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Kijewski MF; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Jerosch-Herold M; CV Imaging Program, Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Kwong RY; CV Imaging Program, Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Ruberg FL; Amyloidosis Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA; Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA., Liao R; Amyloidosis Program, Stanford University, Stanford, California, USA., Di Carli MF; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; CV Imaging Program, Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Falk RH; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA., Dorbala S; Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiac Amyloidosis Program, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; CV Imaging Program, Cardiovascular Division and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA. Electronic address: sdorbala@bwh.harvard.edu. |
| المصدر: | JACC. Cardiovascular imaging [JACC Cardiovasc Imaging] 2024 Aug; Vol. 17 (8), pp. 911-922. Date of Electronic Publication: 2024 Jul 10. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101467978 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-7591 (Electronic) Linking ISSN: 18767591 NLM ISO Abbreviation: JACC Cardiovasc Imaging Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York : Elsevier |
| مواضيع طبية MeSH: | Radiopharmaceuticals*/administration & dosage , Ethylene Glycols* , Predictive Value of Tests* , Aniline Compounds* , Positron Emission Tomography Computed Tomography* , Immunoglobulin Light-chain Amyloidosis*/diagnostic imaging , Immunoglobulin Light-chain Amyloidosis*/metabolism , Immunoglobulin Light-chain Amyloidosis*/mortality , Natriuretic Peptide, Brain*/blood , Peptide Fragments*/metabolism , Peptide Fragments*/blood, Humans ; Female ; Male ; Middle Aged ; Aged ; Prognosis ; Risk Factors ; Ventricular Function, Left ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/metabolism ; Time Factors ; Heart Failure/diagnostic imaging ; Heart Failure/metabolism ; Biomarkers/blood ; Heart Transplantation/adverse effects ; Risk Assessment ; Cardiomyopathies/diagnostic imaging ; Cardiomyopathies/metabolism ; Cardiomyopathies/mortality ; Immunoglobulin Light Chains/metabolism |
| مستخلص: | Background: Positron emission tomography/computed tomography (PET/CT) with 18 F-florbetapir, a novel amyloid-targeting radiotracer, can quantify left ventricular (LV) amyloid burden in systemic light-chain (AL) amyloidosis. However, its prognostic value is not known. Objectives: The authors' aim was to evaluate the prognostic value of LV amyloid burden quantified by 18 F-florbetapir PET/CT, and to identify mechanistic pathways mediating its association with outcomes. Methods: A total of 81 participants with newly diagnosed AL amyloidosis underwent 18 F-florbetapir PET/CT imaging. Amyloid burden was quantified using 18 F-florbetapir LV uptake as percent injected dose. The Mayo stage for AL amyloidosis was determined using troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and free light chain levels. Major adverse cardiac events (MACE) were defined as all-cause death, heart failure hospitalization, or cardiac transplantation within 12 months. Results: Among participants (median age, 61 years; 57% males), 36% experienced MACE, increasing from 7% to 63% across tertiles of LV amyloid burden (P < 0.001). LV amyloid burden was associated with MACE (HR: 1.46; 95% CI: 1.16-1.83; P = 0.001). However, this association became nonsignificant when adjusted for Mayo stage. In mediation analysis, the association between LV amyloid burden and MACE was mediated by NT-proBNP (P < 0.001), a marker of cardiomyocyte stretch and heart failure, and a component of Mayo stage. Conclusions: In this first study to link cardiac 18 F-florbetapir uptake to subsequent outcomes, LV amyloid burden estimated by percent injected dose predicted MACE in AL amyloidosis. This effect was not independent of Mayo stage and was mediated primarily through NT-proBNP. These findings provide novel insights into the mechanism linking myocardial amyloid deposits to MACE. Competing Interests: Funding Support and Author Disclosures This work was supported by the National Institutes of Health. Dr Dorbala was supported by grants R01 HL 130563; K24 HL 157648; AHA16 CSA 2888 0004; AHA19SRG34950011. Dr Falk was supported by a grant R01 HL 130563. Dr Liao was supported by grants AHA16 CSA 2888 0004; AHA19SRG34950011. Dr Ruberg was supported by grants R01 HL 130563; R01 HL 093148. Dr Bianchi was partially supported by a grant K08 CA245100; and has received consulting fees from Prothena. Dr Clerc has received a research fellowship from the International Society of Amyloidosis and Pfizer. Dr Cuddy was supported by grants NIH 1K23HL166686-01 and AHA 23CDA857664NIH; and has received an investigator-initiated research grant from Pfizer; and has received consulting fees from BridgeBio, Ionis, AstraZeneca, and Novo Nordisk. Dr DiCarli has received a research grant from Gilead and Alnylam Pharmaceuticals; in-kind research support from Amgen; and consulting fees from Sanofi, MedTrace Pharma, and Valo Health. Dr Kwong has received grant funding from Alynlam Pharmaceuticals. Dr Falk has received consulting fees from Ionis Pharmaceuticals, Alnylam Pharmaceuticals, Caelum Biosciences; and research funding from GlaxoSmithKline and Akcea. Dr Ruberg has received consulting fees from AstraZeneca, and Attralus; and has received research support from Pfizer, Alnylam, Anumana, and Ionis/Akcea. Dr Dorbala has received consulting fees from Pfizer, GE Health Care, and Novo Nordisk; and investigator-initiated grants from Pfizer, GE Healthcare, Attralus, Siemens, and Philips. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Update of: medRxiv. 2023 Sep 14:2023.09.13.23295520. doi: 10.1101/2023.09.13.23295520. (PMID: 37745589) |
| فهرسة مساهمة: | Keywords: (18)F-florbetapir; adverse outcomes; cardiomyopathy; light-chain (AL) amyloidosis; mediation analysis; positron emission tomography (PET) |
| المشرفين على المادة: | 0 (Radiopharmaceuticals) 6867Q6IKOD (florbetapir) 0 (Ethylene Glycols) 0 (Aniline Compounds) 0 (pro-brain natriuretic peptide (1-76)) 114471-18-0 (Natriuretic Peptide, Brain) 0 (Peptide Fragments) 0 (Biomarkers) 0 (Immunoglobulin Light Chains) |
| تواريخ الأحداث: | Date Created: 20240713 Date Completed: 20240807 Latest Revision: 20240807 |
| رمز التحديث: | 20240808 |
| DOI: | 10.1016/j.jcmg.2024.05.002 |
| PMID: | 39001731 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1876-7591 |
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| DOI: | 10.1016/j.jcmg.2024.05.002 |