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Left ventricular global function index by magnetic resonance imaging - a novel marker for differentiating cardiac

Shan Huang1, Hua-Yan Xu2, Kai-Yue Diao1

  • 1Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan, 610041, China.

Scientific Reports
|March 15, 2020
PubMed

Insights

Left ventricular global function index (LVGFI) effectively differentiates cardiac amyloidosis (CA) from hypertrophic cardiomyopathy (HCM) using cardiovascular magnetic resonance imaging. This novel parameter aids in diagnosing CA, even with similar hypertrophy and preserved ejection fraction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomarkers

Background:

  • Differentiating cardiac amyloidosis (CA) from hypertrophic cardiomyopathy (HCM) is challenging, especially with preserved left ventricular ejection fraction (LVEF) and similar hypertrophy.
  • Accurate differentiation is crucial for appropriate patient management and treatment strategies.

Purpose of the Study:

  • To evaluate the efficacy of left ventricular global function index (LVGFI) and myocardial contraction fraction (MCF) in distinguishing CA from HCM using contrast-agent-free cardiovascular magnetic resonance imaging (CMR).
  • To assess LVGFI's diagnostic performance in specific challenging subgroups, including those with similar hypertrophy and preserved LVEF.

Main Methods:

  • A retrospective study included 68 CA patients, 90 HCM patients, and 35 healthy controls.
  • Cardiovascular magnetic resonance imaging (CMR) was performed without contrast agents.
  • Left ventricular global function index (LVGFI) and myocardial contraction fraction (MCF) were calculated and analyzed for diagnostic performance.

Main Results:

  • LVGFI demonstrated excellent diagnostic performance in differentiating CA from HCM (AUC = 0.91).
  • LVGFI maintained high accuracy in challenging subgroups: similar hypertrophy (AUC = 0.92) and preserved LVEF (AUC = 0.90).
  • LVGFI showed significant correlations with LGE extent, NT-proBNP, and troponin T (p < 0.001) and was an independent predictor of CA (OR = 1.11, p = 0.034).

Conclusions:

  • LVGFI is a novel, clinically valuable parameter for assessing myocardial function.
  • LVGFI exhibits excellent capability in differentiating cardiac amyloidosis from hypertrophic cardiomyopathy, even in complex cases.

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