Diagnosing Transthyretin Cardiac Amyloidosis by Technetium Tc 99m Pyrophosphate
| Autor: | Timothy J. Poterucha, Sabahat Bokhari, Jan M. Griffin, Mathew S. Maurer, Adler J. Perotte, Sunil E. Saith, Lynne L. Johnson, Andrew J. Einstein, Mona Kinkhabwala, Kathleen R Flaherty, Albert DeLuca, Pierre Elias |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test biology Amyloid business.industry Amyloidosis 030204 cardiovascular system & hematology Scintigraphy medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences Transthyretin 0302 clinical medicine Cardiac amyloidosis Spect imaging biology.protein Medicine Radiology Nuclear Medicine and imaging Radiology Cardiology and Cardiovascular Medicine business Heart failure with preserved ejection fraction Emission computed tomography |
| Zdroj: | JACC: Cardiovascular Imaging. 14:1221-1231 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2020.08.027 |
| Popis: | Objectives This study aimed to characterize trends in technetium Tc 99m pyrophosphate (99mTc-PYP) scanning for amyloid transthyretin cardiac amyloidosis (ATTR-CA) diagnosis, to determine whether patients underwent appropriate assessment with monoclonal protein and genetic testing, to evaluate use of single-photon emission computed tomography (SPECT) in addition to planar imaging, and to identify predictive factors for ATTR-CA. Background 99mTc-PYP scintigraphy has been repurposed for noninvasive diagnosis of ATTR-CA. Increasing use of 99mTc-PYP can facilitate identification of ATTR-CA, but appropriate use is critical for accurate diagnosis in an era of high-cost targeted therapeutics. Methods Patients undergoing 99mTc-PYP scanning 1 h after injection at a quaternary care center from 2010 to 2019 were analyzed; clinical information was abstracted; and SPECT results were analyzed. Results Over the decade, endomyocardial biopsy rates remained stable with scanning rates peaking at 132 in 2019 (p Conclusions Use of noninvasive testing with 99mTc-PYP scanning for evaluation of ATTR-CA is increasing, and the inclusion of monoclonal protein testing and SPECT imaging is crucial to rule out amyloid light chain amyloidosis and distinguish myocardial retention from blood pooling. |
| Databáze: | OpenAIRE |
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