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Role of cardiac scintigraphy with ⁹⁹mTc-DPD in the differentiation of cardiac amyloidosis subtype.
- Source :
-
Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2012 May; Vol. 65 (5), pp. 440-6. Date of Electronic Publication: 2012 Mar 30. - Publication Year :
- 2012
-
Abstract
- Introduction and Objectives: We investigated the diagnostic accuracy of (99m)Tc-3,3-diphosphono-1,2 propanodicarboxylic acid ((99m)Tc-DPD) scintigraphy in differentiating between monoclonal immunoglobulin light chain and transthyretin-related cardiac amyloidosis.<br />Methods: Nineteen patients with documented cardiac amyloidosis were included: 8 with transthyretin-related amyloidosis (group A) and 11 with light chain amyloidosis (group B). All the patients underwent scintigraphy with (99m)Tc-DPD and (99m)Tc-methylene diphosphonate ((99m)Tc-MDP).<br />Results: On visual scoring, cardiac (99m)Tc-DPD uptake could be characterized as moderate to severe (scores of 2-3), with ventricular or biventricular distribution, in all group A patients (transthyretin-related cardiac amyloidosis), and was absent or mild (scores of 0-1) and diffusely distributed in all group B patients (monoclonal immunoglobulin light chain cardiac amyloidosis). (99m)Tc-DPD uptake was also absent (score of 0) among unaffected controls and in 2 unaffected relatives of patients with hereditary transthyretin-related amyloidosis who harbor a mutation in the TTR gene. With (99m)Tc-MDP, all the patients had a myocardial uptake score of 0-1. In our series, selective myocardial uptake of (99m)Tc-DPD provided 100% accuracy (95% confidence interval, 97.37%-100%) for the differentiation between transthyretin-related and monoclonal immunoglobulin light chain cardiac amyloidosis.<br />Conclusions: We conclude that (99m)Tc-DPD scintigraphy is a useful test for the differential diagnosis of transthyretin vs monoclonal immunoglobulin light chain etiology in patients with cardiac amyloidosis.<br /> (Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Radionuclide Imaging
Amyloidosis diagnostic imaging
Cardiomyopathies diagnostic imaging
Diphosphonates
Immunoglobulin Light Chains
Organotechnetium Compounds
Paraproteinemias diagnostic imaging
Prealbumin genetics
Radiopharmaceuticals
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 1885-5857
- Volume :
- 65
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Revista espanola de cardiologia (English ed.)
- Publication Type :
- Academic Journal
- Accession number :
- 22464102
- Full Text :
- https://doi.org/10.1016/j.recesp.2011.12.015