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Master Thesis

Myocardial perfusion heterogeneity index in patients with amyloid senile cardiomyopathy : sign of coronary microvascular disease?

Abstract : Objectives: The objective of the study was to compare myocardial perfusion heterogeneity index (MPHI) between patients with amyloid senile cardiomyopathy and a control population. Aging of population is a reality in our society, with a strong increase in number of elderly patients hospitalized for heart failure. Aging is responsible for the onset of senile amyloid cardiomyopathy. Coronary microvascular disease (CMVD) could play a significant role in physiopathology. Our team (UMR 1039) has developed a new method of precise analysis allowing the quantification of myocardial perfusion imaging by MPHI. We compare MPHI between cardiac amyloidosis patients and a control population. We prospectively enrolled in this study 22 patients who presented > 1 heart failure episode with diagnosis of cardiac senile amyloidosis. All patients underwent cardiac Single-photon perfusion tomoscintigraphy (SPECT) with measure of MPHI. Results was compared with control population matched 1:1 by age and cardiovascular risk factors. In the amyloid group, the median age was 83.5 [8.2] years; 86% of patients were male and 13% of patients had ischemic symptoms of chest pain. The median LV wall thickness was significantly higher in the amyloid group than in the control group (15mm [3.5] vs. 9.0 mm [1.7]; p <0.01) and median mass was also higher in the amyloid group than in the control group (154.5g/m² [70.7] vs. 102g/m² [21.5]; p<0.01). MPHI was significantly higher in the amyloid group than in the control group (4.57 [0.47] vs. 4.31[0.42]; p = 0.03). In multivariate analysis, cardiac amyloidosis diagnosis was correlated with MPHI (beta = 0.63; p < 0.01) after adjusted by confounders variables (mass and age). For the differentiation between control population and cardiac amyloidosis patients, MPHI exhibit promising accuracy with an area under the curve (AUC) of 0.66 [95%CI, 0.49-0.83]. MPHI is higher in the amyloid group and this result suggested a link with CMVD.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03468959
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Tuesday, December 7, 2021 - 2:14:56 PM
Last modification on : Saturday, January 1, 2022 - 3:33:23 AM

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  • HAL Id : dumas-03468959, version 1
  • PPN : 24331230X

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Lauriane Gonzalez. Myocardial perfusion heterogeneity index in patients with amyloid senile cardiomyopathy : sign of coronary microvascular disease?. Human health and pathology. 2020. ⟨dumas-03468959⟩

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