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Meta-Analysis
. 2024 Aug 16;10(8):1303-1311.
doi: 10.3390/tomography10080097.

Monitoring the Efficacy of Tafamidis in ATTR Cardiac Amyloidosis by MRI-ECV: A Systematic Review and Meta-Analysis

Shingo Kato  1 , Mai Azuma  2 , Nobuyuki Horita  3 , Daisuke Utsunomiya  1
Affiliations
Meta-Analysis

Monitoring the Efficacy of Tafamidis in ATTR Cardiac Amyloidosis by MRI-ECV: A Systematic Review and Meta-Analysis

Shingo Kato et al. Tomography. .

Abstract

Background: The usefulness of monitoring treatment effect of tafamidis using magnetic resonance imaging (MRI) extracellular volume fraction (ECV) has been reported.

Objective: we conducted a meta-analysis to evaluate the usefulness of this method.

Methods: Data from 246 ATTR-CMs from six studies were extracted and included in the analysis. An inverse variance meta-analysis using a random effects model was performed to evaluate the change in MRI-ECV before and after tafamidis treatment. The analysis was also performed by classifying the patients into ATTR-CM types (wild-type or hereditary).

Results: ECV change before and after tafamidis treatment was 0.33% (95% CI: -1.83-2.49, I2 = 0%, p = 0.76 for heterogeneity) in the treatment group and 4.23% (95% CI: 0.44-8.02, I2 = 0%, p = 0.18 for heterogeneity) in the non-treatment group. The change in ECV before and after treatment was not significant in the treated group (p = 0.76), but there was a significant increase in the non-treated group (p = 0.03). There was no difference in the change in ECV between wild-type (95% CI: -2.65-3.40) and hereditary-type (95% CI: -9.28-4.28) (p = 0.45).

Conclusions: The results of this meta-analysis suggest that MRI-ECV measurement is a useful imaging method for noninvasively evaluating the efficacy of tafamidis treatment for ATTR-CM.

Keywords: cardiac MRI; cardiac amyloidosis; extracellular volume fraction; meta-analysis; tafamidis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Comparison of the change in MRI-ECV before and after tafamidis treatment.
Figure 3
Figure 3
Comparison of the change in MRI-ECV before and after tafamidis treatment of wild type and hereditary ATTR-CM.
See this image and copyright information in PMC

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