Role of 99mTc-DPD scintigraphy in diagnosis and prognosis of hereditary transthyretin-related cardiac amyloidosis

Claudio Rapezzi, Candida C. Quarta, Pier Luigi Guidalotti, Cinzia Pettinato, Stefano Fanti, Ornella Leone, Alessandra Ferlini, Simone Longhi, Massimiliano Lorenzini, Letizia Bacchi Reggiani, Christian Gagliardi, Pamela Gallo, Caterina Villani, Fabrizio Salvi

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: In a cohort of patients with hereditary transthyretin-related amyloidosis (ATTR), we aimed to assess the role of 99mTc-3,3- diphosphono-1,2-propanodicarboxylic acid ( 99mTc-DPD) in detecting myocardial amyloid infiltration across a wide spectrum of cardiac involvement and in predicting major adverse cardiac events (MACE). Background: Hereditary transthyretin-related amyloidosis is a challenging and underdiagnosed condition where both early diagnosis and prognosis remain problematic. Methods: We evaluated 63 patients with ATTR: 40 with and 23 without echocardiographically diagnosed amyloidotic cardiomyopathy (AC). Myocardial uptake of 99mTc-DPD scintigraphy was semiquantitatively and visually assessed at 5 min and 3 h. Results: All patients with AC showed moderate-to-severe myocardial tracer uptake (i.e., visual score 12 mm in combination with H/WB >7.5 was associated with the highest event rate. Conclusions: In ATTR, 99mTc-DPD scintigraphy can identify myocardial infiltration across a wide spectrum of morphologic/functional cardiac involvement, allowing an early diagnosis of the disease (even before the appearance of echocardiographic abnormalities). The 99mTc-DPD myocardial uptake is a prognostic determinant of "cardiac" outcome in ATTR, either alone or in combination with LV wall thickness.

Original languageEnglish
Pages (from-to)659-670
Number of pages12
JournalJACC: Cardiovascular Imaging
Volume4
Issue number6
DOIs
Publication statusPublished - Jun 2011

Keywords

  • Tc-DPD scintigraphy
  • cardiac amyloidosis
  • diagnosis
  • hereditary transthyretin-related amyloidosis
  • prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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