Value of T1mapping imaging combined with left atrial strain in differentia-ting cardiac amyloidosis from hypertrophic cardiomyopathy
Objective To explore non-contrast enhanced cardiac magnetic resonance T1 map-ping and left atrial feature tracking techniques to distinguish cardiac amyloidosis(CA)from hy-pertrophic cardiomyopathy(HCM).Methods A retrospective analysis was conducted on 80 patients who underwent cardiac magnetic resonance examinations from January 2021 to Novem-ber 2023 at 1.5 T and 3.0 T systems in The First Affiliated Hospital of Harbin Medical Univer-sity.Measurements of global left ventricular myocardial T1 values were performed,a standard-ized T1 z-score used as an assessment metric to overcome the effects of various manufacturers and field strengths.Left atrial strain was measured with feature tracking techniques.Left atrial function at different time periods were analyzed.Results A total of 32 CA patients,48 HCM patients,and 30 healthy subjects were analyzed.For both 1.5 T and 3.0 T systems,the over-all T1 values of LV myocardium was significantly higher in the CA group compared with the HCM and control groups(P<0.001).T1z-scores in the CA and HCM groups were 4.8±2.2 and 3.4±1.9,respectively(P<0.001).Myocardial strain analysis showed that strain was significantly lower in the CA group when compared with the HCM and healthy control groups(P<0.05).The DeLong's test showed that the area under curve(AUC)of Es(AUC=0.884)was the highest.A combination model including T1z-score and Es had an improved a-bility to discriminate CA and HCM with a higher AUC=0.914,with a sensitivity of 95%and a specificity of 74.8%(P<0.05).Conclusion T1 mapping combined with left atrial reser-voir function(Es)could effectively distinguish CA from HCM,and provide new insights for the diagnosis of the etiology and treatment of cardiac hypertrophic diseases.
cardiac amyloidosishypertrophic cardiomyopathycardiac magnetic resonancefeature trackingT1z-score
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