99mTc-DPD scintigraphy in immunoglobulin light chain (AL) cardiac amyloidosis.

Autor:	Quarta CC; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK.; Alexion Pharmaceutical LTD, Stockley Park, 3 Furzeground Way, Hayes, Uxbridge, London UB11 1EZ, UK., Zheng J; Cardiovascular Center, University Hospital of Ferrara, Ferrara, Italy., Hutt D; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Grigore SF; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Manwani R; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Sachchithanantham S; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Mahmood SA; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Whelan CJ; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Fontana M; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Martinez-Naharro A; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Chacko L; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Lachmann HJ; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Gillmore JD; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Rapezzi C; Cardiovascular Center, University Hospital of Ferrara, Ferrara, Italy.; Maria Cecilia Hospital, GVM Care & Research, Cotignola, RA, Italy., Hawkins PN; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK., Wechalekar AD; National Amyloidosis Centre, University College London (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2021 Oct 19; Vol. 22 (11), pp. 1304-1311.
DOI:	10.1093/ehjci/jeab095
Abstrakt:	Aims: Technetium-99m-labelled 3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD scintigraphy) is recognized as highly accurate for the non-invasive diagnosis of transthyretin (ATTR) cardiac amyloidosis (CA). A proportion of patients with immunoglobulin light chain (AL) CA have also been reported to show cardiac 99mTc-DPD uptake. Herein, we assessed the frequency and degree of cardiac 99mTc-DPD uptake and its clinical significance among patients with AL CA. Methods and Results: Between 2010 and 2017, 292 consecutive patients with AL CA underwent 99mTc-DPD scintigraphy and were included in this study: 114 (39%) had cardiac 99mTc-DPD uptake: grade 1 in 75%, grade 2 in 17%, and grade 3 in 8% of cases. Patients with cardiac 99mTc-DPD uptake had poorer cardiac systolic function and higher N-terminal pro-brain natriuretic peptide. No differences were noted in cardiac magnetic resonance parameters between patients with and without cardiac 99mTc-DPD uptake (N = 19 and 42, respectively). Patients with cardiac 99mTc-DPD uptake showed a trend to worse survival than those with no uptake (log-rank P = 0.056). Among 22 patients who underwent serial 99mTc-DPD scintigraphy, 5 (23%) showed reduction in the grade of cardiac uptake. Conclusions: In this large cohort of patients with AL CA, 99mTc-DPD scintigraphy ∼40% of cases showed cardiac uptake, including grade 2-3 in 10% of all patients (25% of those with cardiac 99mTc-DPD uptake). Cardiac 99mTc-DPD uptake was associated with poorer cardiac function and outcomes. These data highlight the critical importance of ruling out AL amyloidosis in all patients with cardiac 99mTc-DPD uptake to ensure such patients are not assumed to have ATTR CA. (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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