Late gadolinium enhancement in cardiac amyloidosis: attributable both to interstitial amyloid deposition and subendocardial fibrosis caused by ischemia

Heart and Vessels
Hiromi HashimuraHiroaki Naito

Abstract

Gadolinium contrast agents used for late gadolinium enhancement (LGE) distribute in the extracellular space. Global diffuse myocardial LGE pronounced in the subendocardial layers is common in cardiac amyloidosis. However, the pathophysiological basis of these findings has not been sufficiently explained. A 64-year-old man was admitted to our hospital with leg edema and nocturnal dyspnea. Bence Jones protein was positive in the urine, and an endomyocardial and skin biopsy showed light-chain (AL) amyloidosis. He died of ventricular fibrillation 3 months later. 9 days before death, the patient was examined by cardiac magnetic resonance (CMR) imaging on a 3-T system. We acquired LGE data at 2, 5, 10, and 20 min after the injection of gadolinium contrast agents, with a fixed inversion time of 350 ms. Myocardial LGE developed sequentially. The myocardium was diffusely enhanced at 2 min, except for the subendocardium, but LGE had extended to almost the entire left ventricle at 5 min and predominantly localized to the subendocardial region at 10 and 20 min. An autopsy revealed massive and diffused amyloid deposits in perimyocytes throughout the myocardium. Old and recent ischemic findings, such as replacement fibrosis and coagulative m...Continue Reading

References

Sep 1, 1979·The American Journal of Cardiology·R R Smith, G M Hutchins
Sep 7, 2000·The American Journal of Medicine·P S MuellerM A Gertz
Jan 5, 2005·Circulation·Alicia Maria MaceiraDudley John Pennell
May 23, 2006·AJR. American Journal of Roentgenology·Rohan I vanden DriesenWendy E Strugnell
Feb 24, 2007·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Christopher M WittichWilliam D Edwards
Mar 8, 2008·Journal of the American College of Cardiology·Holger VogelsbergUdo Sechtem
Oct 18, 2008·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Waldemar HoschThomas Longerich
Nov 27, 2008·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Alicia M MaceiraDudley J Pennell
Jan 6, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Atsuhiko YagishitaKazuhiro Hara
Feb 18, 2010·JACC. Cardiovascular Imaging·Imran S SyedMartha Grogan
Nov 26, 2010·AJR. American Journal of Roentgenology·Gianluca Di BellaMichele Gaeta
Apr 21, 2011·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Stephanie B TsaiVaishali Sanchorawala
Nov 28, 2012·Journal of Forensic Sciences·Jason MorinCarol Lee
Aug 7, 2013·International Journal of Cardiology·Fabio MinutoliSergio Baldari

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Citations

Jan 28, 2017·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Hiromi HashimuraHiroaki Naito
Mar 24, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Hatsue Ishibashi-UedaYoshihiko Ikeda
Nov 11, 2017·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Marco M OchsSebastian J Buss
May 23, 2020·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Seitaro OdaYasuyuki Yamashita
Oct 9, 2019·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Toru AwayaMasao Moroi
Sep 11, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Miwa IshidaTakayuki Inomata
Jul 15, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Shahryar G SabaRakesh D Shah
Jul 18, 2019·JACC. Basic to Translational Science·Kathleen W ZhangDaniel J Lenihan

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