Known cardiac amyloid, continued evaluation of disease burden. . Left VentricleThe left ventricle is normal in size with mildly decreased systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 70 ml/m2 (normal range: 74+/-15), the LVEDV is 145 ml (normal range 142+/-34), the LV end systolic volume index is 38 ml/m2 (normal range 25+/-9), the LVESV is 79 ml (normal range 47+/-19). There is concentric LVH. There are no regional wall motion abnormalities present. . There is diffuse late gadolinium enhancement to suggest the presence of an underlying fibrosing process.The native T1 myocardial relaxation times range from 1084-1343 ms which is grossly abnormal.Left AtriumThe left atrium is dilated. Right VentricleThe right ventricle is normal in size with low systolic function. The overall RV ejection fraction is 37%, the RV end diastolic volume index is 81 ml/m2 (normal range 82+/-16), the RVEDV is 167 ml (normal range 142+/-31), the RV end systolic volume index is 51 ml/m2 (normal range 31+/-9), and the RVESV is 104 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumSmall pericardial effusion. There is no obvious pericardial disease.Extracardiac FindingsSignificant BL pleural effusions.. This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. The left ventricle ejection fraction is decreased at 45% with concentric hypertrophy of the ventricle.3. There is late gadolinium enhancement in a diffuse pattern of the myocardium, which in clinical context are suggestive of the presence of cardiac amyloid. 4. Native T1 mapping also suggests abnormal myocardial signal consistent with amyloid.5. The right ventricle systolic function is decreased at 37%. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.