Multiple myeloma (MM) is a hematological malignancy of plasma cell origin. Cardiac amyloidosis (CA) is a common form of heart damage caused by MM and is associated with a poor prognosis. This study was a prospective cohort study and was aimed at evaluating the clinical predictive value of extracellular volume fraction (ECV) based on cardiovascular magnetic resonance (CMR) T1 mapping for cardiac amyloidosis and cardiac dysfunction in MM patients. Fifty-one newly diagnosed MM patients in Zhongnan Hospital of Wuhan University were enrolled in the study. A total of 19 patients (19/51; 37.25%) developed CA. The basal ECV of CA group was significantly higher than that of the non-CA group (). Multivariate logistic regression analysis showed that basal ECV (, 95% CI 1.084-2.219, ) and LDH1 level (, 95% CI 1.010-1.310, ) were two independent risk factors for CA. Further study demonstrated that basal ECV in the heart failure group was significantly higher than that of the nonheart failure group (). Notably, ROC curve showed that basal ECV had a good predictive value for CA and heart failure, with AUC of 0.911 and 0.893 (all ), and the best cutoff values of 38.35 and 37.45, respectively. Taken together, basal ECV is a good predictor of CA and heart failure for MM patients.

中文翻译：

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基于心脏磁共振 T1 映射的细胞外体积分数：评估多发性骨髓瘤患者心脏淀粉样变性所致心脏损伤的有效方法

多发性骨髓瘤 (MM) 是浆细胞起源的血液系统恶性肿瘤。心脏淀粉样变性 (CA) 是由 MM 引起的常见心脏损伤形式，与预后不良有关。本研究是一项前瞻性队列研究，旨在评估基于心血管磁共振 (CMR) T1 映射的细胞外体积分数 (ECV) 对 MM 患者心脏淀粉样变性和心功能不全的临床预测价值。武汉大学中南医院51名新诊断的MM患者被纳入研究。共有 19 名患者（19/51；37.25%）发展为 CA。CA组基础ECV显着高于非CA组（）。多因素logistic回归分析显示，基础ECV（, 95% CI 1.084-2.219,)和 LDH1 水平 (, 95% CI 1.010-1.310,)是 CA 的两个独立危险因素。进一步研究表明，心力衰竭组的基础 ECV 显着高于非心力衰竭组（）。值得注意的是，ROC 曲线显示基础 ECV 对 CA 和心力衰竭具有良好的预测价值，AUC 分别为 0.911 和 0.893（均)，最佳截止值分别为 38.35 和 37.45。总之，基础 ECV 是 MM 患者 CA 和心力衰竭的良好预测指标。