Related Experiment Video

Updated: Mar 21, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

2.2K

Prognostic value of left atrial function in systemic light-chain amyloidosis: a cardiac magnetic resonance study

Dania Mohty1, Cyrille Boulogne2, Julien Magne2

  • 1CHU Dupuytren, Limoges, France French National Reference Center for Light chains Amyloidosis and Other Diseases by Monoclonal Immunoglobulin Deposits, Limoges University, Limoges, France dania.mohty@chu-limoges.fr.

European Heart Journal. Cardiovascular Imaging
|May 20, 2016
PubMed
Abstract

Insights

Left atrial emptying fraction (LAEF) measured by cardiac magnetic resonance (CMR) is a significant predictor of survival in systemic light-chain amyloidosis (AL). Lower LAEF indicates a higher risk of mortality, highlighting its prognostic value in AL heart disease.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Oncology

Background:

  • Cardiac involvement in systemic light-chain amyloidosis (AL) significantly impacts patient outcomes.
  • The left atrium (LA) is frequently affected by amyloid infiltration, leading to reduced function and enlargement.
  • Left atrial volume (LAV) is a known prognostic marker in other cardiomyopathies, but its role in AL heart disease requires further investigation.

Purpose of the Study:

  • To assess the prognostic significance of maximal left atrial volume (LAV) and total left atrial emptying fraction (LAEF) in patients with systemic AL using cardiac magnetic resonance (CMR).
  • To determine the relationship between LA parameters and disease severity, symptoms, and mortality in AL patients.

Main Methods:

  • Cardiac magnetic resonance (CMR) imaging was performed on 54 consecutive patients with confirmed systemic AL.
  • Maximal and minimal left atrial volumes (LAV) and left atrial emptying fraction (LAEF) were measured.
  • Correlation with Mayo Clinic (MC) stage, New York Heart Association (NYHA) functional class, myocardial late gadolinium enhancement (LGE), and 2-year survival rates was analyzed.

Main Results:

  • Patients with moderate to high cardiac involvement (MC stages II and III) exhibited significantly larger LAV and lower LAEF compared to those with minimal involvement (MC stage I).
  • Lower LAEF was significantly associated with the presence of myocardial late gadolinium enhancement (LGE) and symptomatic disease (NYHA class ≥ II).
  • A two-year survival rate of 37% was observed in patients with LAEF ≤ 16%, compared to 94% in those with LAEF > 16% (P = 0.001).
  • Multivariate analysis confirmed that lower LAEF independently predicted a higher risk of 2-year mortality (HR = 1.08 per 1% decrease, P = 0.003).

Conclusions:

  • Left atrial emptying fraction (LAEF), as assessed by CMR, is a valuable prognostic marker in systemic AL.
  • LAEF is associated with disease severity (MC stage), symptoms (NYHA class), and myocardial damage (LGE) in AL patients.
  • Reduced LAEF is an independent predictor of mortality in systemic AL, underscoring its clinical importance.
Keywords:
AL amyloidosisCardiac magnetic resonanceLeft atrial functionPrognosis

More Related Videos

Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse12:24

Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse

Published on: June 20, 2014

10.5K
Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats08:09

Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats

Published on: December 13, 2019

23.2K

Related Concept Videos

Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
395
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
826
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
751
Mitral Regurgitation II: Clinical Features and Diagnostic Tests01:23

Mitral Regurgitation II: Clinical Features and Diagnostic Tests

Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
740
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
953
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
407