Author + information
- Ahmad Masri,
- Ricardo Nieves,
- Michael S. Sharbaugh,
- Andrew Althouse,
- William Follansbee,
- Joao Cavalcante and
- Prem Soman
Background: Transthyretin cardiac amyloidosis (ATTR CA) is an underdiagnosed cause of heart failure with reported worse outcomes. Technetium Pyrophosphate scintigraphy (PYP) has re-emerged as a tool to non-invasively diagnose ATTR CA. We sought to determine the clinical and echocardiographic predictors of a positive Tc-PYP scan in patients with suspected CA.
Methods: Consecutive patients with suspected CA who were referred for PYP were analyzed. A positive scan was defined by increased cardiac uptake of Tc-PYP tracer as compared to the contralateral side and bone. Baseline clinical, electrocardiographic (ECG), and echocardiographic characteristics were compared between PYP +ve and PYP -ve patients. Diastolic function was graded based on the 2009 American Society of Echocardiography guidelines.
Results: Among 68 consecutive patients (mean age 67.9 years, 64.7% males), 25 (37%) were PYP +ve. Subjects testing positive were older (79.2 vs 73.5 years), had a higher prevalence of first degree atrioventricular block (AVB, 32% vs 2.3%), low QRS voltage (24% vs 4.7%), increased left ventricular wall (LV) thickness and worse diastolic function (≥Grade II; 56% vs 34.9%) Table 1. There was no difference in LAVI (41 vs 46 cm/m2) or PASP (38.5 vs 37 mmHg).
Conclusions: Identifying patients with ATTR CA clinically remains challenging. Grade II or more diastolic dysfunction, thicker LV, low QRS voltage and first degree AVB are more common in patients with a positive Tc-PYP scintigraphy.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-9:55 a.m.
Session Title: Emerging Applications for Imaging Cardiac Amyloidosis: Nuclear Cardiology
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1307M-03
- 2017 American College of Cardiology Foundation