Inverse correlation between age of onset and myocardial amyloid deposition quantified by 99mTc-PYP scintigraphy in patients with wild-type transthyretin amyloid cardiomyopathy

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Annals of Nuclear Medicine Pub Date : 2024-06-14 DOI:10.1007/s12149-024-01943-3
Hiroshi Kanaya, Shinya Shiraishi, Kouji Ogasawara, Koya Iwashita, Fumi Sakamoto, Seiji Takashio, Yoshiki Mikami, Kenichi Tsujita, Toshinori Hirai
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Abstract

Objective

Wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) is increasingly recognized as a contributing factor to cardiac insufficiency in the elderly population. We aimed to identify the factors affecting age of onset of ATTRwt-CM, encompassing the assessment of amyloid deposition in myocardial tissue through the use of 99mTc-pyrophosphate (PYP) and clinical parameters.

Methods

A retrospective investigation involving a consecutive cohort of 107 cases, each having been diagnosed with ATTRwt-CM confirmed through histopathological and genetic analysis, was performed. All patients underwent PYP scintigraphy, and the heart-to-contralateral (H/CL) ratio was calculated to measure amyloid deposition in the myocardium. Univariate and multivariate analyses were performed to identify independent predictors of the age of onset of ATTRwt-CM, considering the H/CL ratio and various clinical risk factors for heart failure.

Results

Gender (p = 0.03), Creatinine (Cr) (r = 0.32, p < 0.01), hemoglobin (Hb) (r =  − 0.44, p < 0.01), albumin (Alb) (r =  − 0.32, p < 0.01), brain natriuretic peptide (BNP) (r = 0.21, p = 0.03), low-density lipoprotein-cholesterol (LDL-C) (r =  − 0.27, p < 0.01), and H/CL ratio (r =  − 0.44, p < 0.01) were all significantly associated with the onset age. In multiple regression analysis, the independent predictive factors for the onset age of ATTRwt-CM were identified as the H/CL ratio (p < 0.01), Hb (p < 0.01), and Cr (p < 0.01).

Conclusion

The H/CL ratio, Hb, and Cr independently affect age of onset in patients with ATTRwt-CM. The H/CL ratio is inversely correlated with age of onset, and may be the sole factor in the development of heart failure in early onset patients, while it may have a synergistic effect on heart failure with anemia and renal dysfunction in late-onset patients.

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野生型转甲状腺素淀粉样变性心肌病患者的发病年龄与通过99m锝-PYP闪烁成像量化的心肌淀粉样沉积之间存在反相关性。
目的:野生型转甲状腺素淀粉样变性心肌病(ATTRwt-CM)越来越被认为是导致老年人心功能不全的一个因素。我们旨在确定影响 ATTRwt-CM 发病年龄的因素,包括通过使用 99mTc 焦磷酸(PYP)和临床参数评估心肌组织中的淀粉样沉积:方法:我们进行了一项回顾性调查,涉及 107 例连续性病例,每例病例均通过组织病理学和基因分析确诊为 ATTRwt-CM。所有患者都接受了PYP闪烁扫描,并计算了心脏与心肌两侧(H/CL)的比率,以测量心肌中的淀粉样沉积。考虑到H/CL比值和心衰的各种临床风险因素,进行了单变量和多变量分析,以确定ATTRwt-CM发病年龄的独立预测因素:性别(P = 0.03)、肌酐(Cr)(r = 0.32,PH/CL比值、Hb和Cr对ATTRwt-CM患者的发病年龄有独立影响。H/CL 比值与发病年龄成反比,可能是早发患者发生心衰的唯一因素,而在晚发患者中,H/CL 比值可能与贫血和肾功能障碍对心衰有协同作用。
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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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