Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Cardiology-CTVS
  • Cardiology & CTVS News
  • ECV mapping, in...

ECV mapping, in systemic AL amyloidosis an independent predictor of prognosis: JAMA

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-08-26T09:00:28+05:30  |  Updated On 26 Aug 2024 9:00 AM IST
ECV mapping, in systemic AL amyloidosis an independent predictor of prognosis: JAMA
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

UK: In a recent study published in JAMA Cardiology, researchers have unveiled new insights into managing systemic immunoglobulin AL amyloidosis, particularly emphasizing the role of extracellular volume (ECV) mapping as a crucial tool for predicting patient outcomes. This revelation marks a significant shift in how clinicians approach treatment for this rare but severe condition characterized by the deposition of amyloid proteins in organs, most critically the heart.

The researchers revealed that ECV mapping reshapes the understanding of hematological responses linked to improved outcomes and holds the promise of guiding more effective treatment strategies. ECV mapping is a technique used to assess the volume of extracellular space in cardiac tissues.

The cohort study encompassed 560 newly diagnosed systemic AL amyloidosis patients who underwent cardiac magnetic resonance (CMR) imaging with ECV mapping before starting chemotherapy. Among various methods for assessing cardiac involvement, ECV mapping emerged as the sole independent prognostic indicator.

"It offered valuable insights into how the depth and speed of hematological response correlate with patient outcomes, highlighting that a swift and substantial hematological response is particularly crucial for those with elevated ECV levels," the researchers wrote.

Systemic light-chain (AL) amyloidosis, a condition resulting from the abnormal accumulation of light-chain amyloid proteins, often leads to severe cardiac complications. Traditionally, treatment strategies have focused primarily on the reduction of amyloid-producing plasma cells and the overall control of disease progression. The key determinant of survival in systemic AL amyloidosis is cardiac amyloid infiltration. Current guidelines advise early therapy modification for patients showing nonoptimal or suboptimal responses, irrespective of the degree of cardiac amyloid infiltration.

Against the above background, Aldostefano Porcari, University College London, Royal Free Hospital, London, United Kingdom, and colleagues aimed to evaluate the differences between serum biomarkers, echocardiography, and CMR with ECV mapping in characterizing cardiac amyloid, the independent prognostic role of these approaches, and the ECV mapping's role to guide treatment strategies.

From 2015 to 2021, consecutive patients newly diagnosed with systemic AL amyloidosis underwent echocardiography, cardiac biomarker assessments, and cardiac magnetic resonance (CMR) imaging with ECV mapping at the time of diagnosis.

The primary outcomes of the study included all-cause mortality and hematological response, categorized into no response (NR), partial response (PR), very good partial response (VGPR), and complete response (CR) based on validated criteria. Secondary outcomes focused on the depth and speed of the hematological response, as well as overall survival with ECV levels.

The following were the key findings of the study:

  • Of 560 patients with AL amyloidosis, the median age was 68 years; 61.8% were males.
  • Over a median of 40.5 months, ECV was independently associated with mortality.
  • In the landmark analysis at one month, long-term survival was independent of the achieved hematological response in ECV less than 0.30% and ECV of 0.31% to 0.40%, while it was dependent on the depth of the hematological response in ECV greater than 0.40%.
  • In the landmark analysis at six months, survival was independent of the achieved hematological response in ECV less than 0.30% and dependent on achieving at least PR in ECV of 0.31% to 0.40%.
  • Survival was dependent on achieving CR in ECV of 0.41% to 0.50% and ECV greater than 0.50%.
  • Achieving a deep hematological response at one month was associated with better survival than six months in patients with ECV greater than 0.40% but not with ECV less than 0.40%.

This study demonstrated that CMR with ECV mapping provides a significant advantage by precisely assessing the presence and extent of cardiac amyloid infiltration, surpassing the accuracy of serum cardiac biomarkers and echocardiography.

"ECV mapping not only independently predicts overall survival in systemic AL amyloidosis but also helps delineate hematological responses that correlate with improved long-term survival based on the degree and severity of cardiac amyloid infiltration," the researchers concluded.

Reference:

Porcari A, Masi A, Martinez-Naharro A, et al. Redefining Cardiac Involvement and Targets of Treatment in Systemic Immunoglobulin AL Amyloidosis. JAMA Cardiol. Published online August 21, 2024. doi:10.1001/jamacardio.2024.2555


JAMA Cardiologysystemic light-chain (AL) amyloidosisextracellular volume mappingcardiovascular magnetic resonance
Source : JAMA Cardiology
Medha Baranwal
Medha Baranwal

    MSc. Biotechnology

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

    Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

    National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

    National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

    Relevance of Pioglitazone in Indian T2DM Care Continuum

    Relevance of Pioglitazone in Indian T2DM Care Continuum

    Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

    Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

    First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

    First Indian Consensus on Managing Refractory Gastroesophageal Reflux Disease Recommends Vonoprazan

    View All

    Journal Club Today

    Study Shows Combination Therapy May Improve Survival in Severe Heart Disease

    Study Shows Combination Therapy May Improve Survival in Severe Heart Disease

    View All

    Health News Today

    Health Bulletin 04/June/2025

    Health Bulletin 04/June/2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok