Images and Case Reports in Heart Failure Improvement in Myocardial Delayed Enhancement After Autologous Stem Cell Transplant in a Patient With

A 55-year-old woman presented with progressive heartfailure symptoms and was diagnosed by endomyocardi-al biopsy with light chain amyloidosis. Magnetic resonance imaging (MRI) at baseline showed slightly increased wall thickness of the right and left ventricles and abnormal nulling of the myocardium with a dark blood pool (Figure A) on postgadolinium images, consistent with amyloidosis. Base-line N-terminal prohormone of brain natriuretic peptide (NT-Pro BNP) level was 1429 pg/mL (normal range 10–168 pg/mL). Three years after autologous peripheral blood stem cell transplant (SCT), she continued to have complete hema-tologic response and had improvement of the heart failure symptoms. NT-Pro BNP level improved to 277 pg/mL. Repeat MRI showed regression of the mildly increased ventricular wall thickness and normal nulling of the myocar-dium (Figure B), with faint residual areas of myocardia