Pub Date : 2024-06-01Epub Date: 2023-11-22DOI: 10.1080/13506129.2023.2286427
Ronald Lands, Emily B Martin, Dustin Powell, Alan Stuckey, Bryan Whittle, Spencer Guthrie, Renju Raj, Stephen J Kennel, Jonathan S Wall
{"title":"Longitudinal PET/CT imaging with iodine (<sup>124</sup>I) evuzamitide reveals organ response to plasma cell immunotherapy in a patient with AL amyloidosis.","authors":"Ronald Lands, Emily B Martin, Dustin Powell, Alan Stuckey, Bryan Whittle, Spencer Guthrie, Renju Raj, Stephen J Kennel, Jonathan S Wall","doi":"10.1080/13506129.2023.2286427","DOIUrl":"10.1080/13506129.2023.2286427","url":null,"abstract":"","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11109018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-01-11DOI: 10.1080/13506129.2023.2295221
Sarah Schreiner, Natalie Berghaus, Alexandra M Poos, Marc S Raab, Britta Besemer, Roland Fenk, Hartmut Goldschmidt, Elias K Mai, Carsten Müller-Tidow, Niels Weinhold, Ute Hegenbart, Stefanie Huhn, Stefan O Schönland
Background: AL amyloidosis (AL) results from the misfolding of immunoglobulin light chains (IG LCs). Aim of this study was to comprehensively analyse kappa LC sequences from AL patients in comparison with multiple myeloma (MM).
Objective: We analysed IGKV/IGKJ usage and associated organ tropism and IGKV1/D-33 in terms of mutational analysis and theoretical biochemical properties.
Material and methods: cDNA and bulk RNA sequencing of the LCs of AL and MM patients.
Results: We studied 41 AL and 83 MM patients showing that IGKV1 was most expressed among kappa AL and MM, with higher frequency in AL (80% vs. 53%, p = .002). IGKV3 was underrepresented in AL (10% vs. 30%, p = .014). IGKJ2 was more commonly used in AL than in MM (39% vs. 29%). Patients with IGKV1/D-33 were associated with heart involvement (75%, p = .024). IGKV1/D-33-segments of AL had a higher mutation count (AL = 12.0 vs. MM = 10.0). FR3 and CDR3 were most frequently mutated in both, with a median mutation count in FR3 being the highest (AL = 4.0; MM = 3.5) and one mutation hotspot (FR3 (83I)) for IGKV1/D-33/IGKJ2 was associated with cardiac involvement.
Conclusion: This study confirmed that germline usage has an influence on AL amyloidosis risk and organ involvement.
背景:肌钙蛋白淀粉样变性(AL)是免疫球蛋白轻链(IG LCs)错误折叠的结果。本研究旨在全面分析 AL 患者与多发性骨髓瘤(MM)患者的卡帕 LC 序列:材料与方法:对 AL 和 MM 患者的 LC 进行 cDNA 和大量 RNA 测序:我们对41例AL和83例MM患者进行了研究,结果显示,IGKV1在kappa AL和MM中表达最多,在AL中的频率更高(80%对53%,p = .002)。IGKV3在AL中的比例较低(10%对30%,P = .014)。IGKJ2在AL中的使用率高于MM(39% vs. 29%)。IGKV1/D-33患者与心脏受累有关(75%,p = .024)。IGKV1/D-33-段的AL患者的突变数量更高(AL = 12.0 vs. MM = 10.0)。两者中FR3和CDR3的突变频率最高,其中FR3的中位突变数最高(AL = 4.0; MM = 3.5),IGKV1/D-33/IGKJ2的一个突变热点(FR3 (83I))与心脏受累有关:本研究证实,种系遗传对AL淀粉样变性风险和器官受累有影响。
{"title":"Sequence diversity of kappa light chains from patients with AL amyloidosis and multiple myeloma.","authors":"Sarah Schreiner, Natalie Berghaus, Alexandra M Poos, Marc S Raab, Britta Besemer, Roland Fenk, Hartmut Goldschmidt, Elias K Mai, Carsten Müller-Tidow, Niels Weinhold, Ute Hegenbart, Stefanie Huhn, Stefan O Schönland","doi":"10.1080/13506129.2023.2295221","DOIUrl":"10.1080/13506129.2023.2295221","url":null,"abstract":"<p><strong>Background: </strong>AL amyloidosis (AL) results from the misfolding of immunoglobulin light chains (IG LCs). Aim of this study was to comprehensively analyse kappa LC sequences from AL patients in comparison with multiple myeloma (MM).</p><p><strong>Objective: </strong>We analysed <i>IGKV/IGKJ</i> usage and associated organ tropism and <i>IGKV1/D-33</i> in terms of mutational analysis and theoretical biochemical properties.</p><p><strong>Material and methods: </strong>cDNA and bulk RNA sequencing of the LCs of AL and MM patients.</p><p><strong>Results: </strong>We studied 41 AL and 83 MM patients showing that <i>IGKV1</i> was most expressed among kappa AL and MM, with higher frequency in AL (80% vs. 53%, <i>p</i> = .002). <i>IGKV3</i> was underrepresented in AL (10% vs. 30%, <i>p</i> = .014). <i>IGKJ2</i> was more commonly used in AL than in MM (39% vs. 29%). Patients with <i>IGKV1/D-33</i> were associated with heart involvement (75%, <i>p</i> = .024). <i>IGKV1/D-33</i>-segments of AL had a higher mutation count (AL = 12.0 vs. MM = 10.0). FR3 and CDR3 were most frequently mutated in both, with a median mutation count in FR3 being the highest (AL = 4.0; MM = 3.5) and one mutation hotspot (FR3 (83I)) for <i>IGKV1/D-33/IGKJ2</i> was associated with cardiac involvement.</p><p><strong>Conclusion: </strong>This study confirmed that germline usage has an influence on AL amyloidosis risk and organ involvement.</p>","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2023-12-21DOI: 10.1080/13506129.2023.2294434
Rim Bourguiba, Alexandre Terré, Lea Savey, Eric Oziol, Thomas Hanslik, Jean-Emmanuel Kahn, Raphael Borie, Alexandre Cez, David Buob, Gilles Grateau, Jean-Jacques Boffa, Sophie Georgin-Lavialle
{"title":"Symptomatic SARS-CoV2 infection associated with high mortality in AA amyloidosis.","authors":"Rim Bourguiba, Alexandre Terré, Lea Savey, Eric Oziol, Thomas Hanslik, Jean-Emmanuel Kahn, Raphael Borie, Alexandre Cez, David Buob, Gilles Grateau, Jean-Jacques Boffa, Sophie Georgin-Lavialle","doi":"10.1080/13506129.2023.2294434","DOIUrl":"10.1080/13506129.2023.2294434","url":null,"abstract":"","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Technetium-99m-pyrophosphate (99mTc-PYP) uptake in the internal oblique muscle (IOM), which is often observed in patients with wild-type transthyretin cardiac amyloidosis (ATTR-CA), indicates amyloid transthyretin (ATTR) deposition.
Objective: This study aimed to assess the safety and efficacy of 99mTc-PYP imaging-based computed tomography (CT)-guided core-needle biopsy of the IOM as a new extracardiac screening biopsy for confirming the presence of ATTR deposits.
Methods: Patients with suspected ATTR-CA in whom myocardial tracer uptake was detected on chest- and abdomen-centered images of 99mTc-PYP scintigraphy underwent CT-guided core-needle biopsy at the site with the highest tracer uptake in the IOM between September 2021 and November 2022.
Results: All 18 consecutive patients (mean age, 86.3 years ± 6.5; 61.1% male) enrolled in the study showed 99mTc-PYP uptake into the IOM. Adequate tissue samples were obtained from all patients except one without serious complications. Immunohistochemical analysis confirmed ATTR deposits in 16/18 (88.9%) patients. In the remaining two patients, ATTR deposits were observed via endomyocardial biopsy. All patients were diagnosed with wild-type ATTR-CA based on transthyretin gene sequence testing results.
Conclusion: In wild-type ATTR-CA, 99mTc-PYP imaging-based CT-guided core-needle biopsy of the IOM could be used as an extracardiac screening biopsy to confirm the presence of ATTR deposits.
{"title":"Technetium-99m-pyrophosphate imaging-based computed tomography-guided core-needle biopsy of internal oblique muscle in wild-type transthyretin cardiac amyloidosis.","authors":"Koji Takahashi, Yoshiyasu Hiratsuka, Takaaki Iwamura, Daisuke Sasaki, Nobuhisa Yamamura, Sohei Kitazawa, Mitsuharu Ueda, Hiroe Morioka, Takafumi Okura, Daijiro Enomoto, Shigeki Uemura, Taizo Kono, Tomoki Sakaue, Shuntaro Ikeda","doi":"10.1080/13506129.2023.2235881","DOIUrl":"10.1080/13506129.2023.2235881","url":null,"abstract":"<p><strong>Background: </strong>Technetium-99m-pyrophosphate (<sup>99m</sup>Tc-PYP) uptake in the internal oblique muscle (IOM), which is often observed in patients with wild-type transthyretin cardiac amyloidosis (ATTR-CA), indicates amyloid transthyretin (ATTR) deposition.</p><p><strong>Objective: </strong>This study aimed to assess the safety and efficacy of <sup>99m</sup>Tc-PYP imaging-based computed tomography (CT)-guided core-needle biopsy of the IOM as a new extracardiac screening biopsy for confirming the presence of ATTR deposits.</p><p><strong>Methods: </strong>Patients with suspected ATTR-CA in whom myocardial tracer uptake was detected on chest- and abdomen-centered images of <sup>99m</sup>Tc-PYP scintigraphy underwent CT-guided core-needle biopsy at the site with the highest tracer uptake in the IOM between September 2021 and November 2022.</p><p><strong>Results: </strong>All 18 consecutive patients (mean age, 86.3 years ± 6.5; 61.1% male) enrolled in the study showed <sup>99m</sup>Tc-PYP uptake into the IOM. Adequate tissue samples were obtained from all patients except one without serious complications. Immunohistochemical analysis confirmed ATTR deposits in 16/18 (88.9%) patients. In the remaining two patients, ATTR deposits were observed <i>via</i> endomyocardial biopsy. All patients were diagnosed with wild-type ATTR-CA based on transthyretin gene sequence testing results.</p><p><strong>Conclusion: </strong>In wild-type ATTR-CA, <sup>99m</sup>Tc-PYP imaging-based CT-guided core-needle biopsy of the IOM could be used as an extracardiac screening biopsy to confirm the presence of ATTR deposits.</p>","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10216790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-09-27DOI: 10.1080/13506129.2023.2260537
Monica Alcantara, Vera Bril
{"title":"Intra-familial variability of oculoleptomeningeal amyloidosis due to the ATTR I107M (c.381T > G) mutation: diagnostic challenges of a rare phenotype.","authors":"Monica Alcantara, Vera Bril","doi":"10.1080/13506129.2023.2260537","DOIUrl":"10.1080/13506129.2023.2260537","url":null,"abstract":"","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41119955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-08-10DOI: 10.1080/13506129.2023.2246797
{"title":"Correction.","authors":"","doi":"10.1080/13506129.2023.2246797","DOIUrl":"10.1080/13506129.2023.2246797","url":null,"abstract":"","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-08-02DOI: 10.1080/13506129.2023.2239986
Maria Ungericht, Valeria Groaz, Moritz Messner, Thomas Schuetz, Luca Brunelli, Marc-Michael Zaruba, Daniela Lener, Eva Stocker, Axel Bauer, Alexander Stephan Kroiss, Agnes Mayr, Christoph Röcken, Gerhard Poelzl
Background: The significance of measuring 99mTc-labelled-3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) in transthyretin (ATTR) cardiac amyloidosis has not been adequately studied. This single-centre observational study evaluated the correlation between 99mTc-DPD scintigraphy and histological amyloid load in endomyocardial biopsy (EMB).
Methods: Twenty-eight patients with biopsy-proven ATTR amyloidosis and concomitantly available 99mTc-DPD scintigraphy were included. Visual Perugini scoring, and (semi-)quantitative analysis of cardiac 99mTc-DPD uptake by planar whole-body imaging and single photon emission computed tomography (SPECT/CT) using regions of interest (ROI) were performed. From this, heart-to-whole-body ratio (H/WB) and heart-to-contralateral-chest ratio (H/CL) were calculated. The histological amyloid load was quantified using two different staining methods.
Results: Increased cardiac tracer uptake was documented in all patients (planar: ROImean 129 ± 37 cps; SPECT/CT: ROImean 369 ± 142 cps). Histological amyloid load (19 ± 13%) significantly correlated with Perugini score (r = 0.69, p < .001) as well as with cardiac 99mTc-DPD uptake (planar: r = 0.64, p < .001; H/WB: r = 0.50, p = .014; SPECT/CT: r = 0.53, p = .008; H/CL: r = 0.43, p = .037) (results are shown for correlations with Congo Red-staining).
Conclusion: In ATTR, cardiac 99mTc-DPD uptake significantly correlated with histological amyloid load in EMB. Further studies are needed to implement thresholds in cardiac 99mTc-DPD uptake measurements for risk stratification and guidance of therapy.
{"title":"Correlation of 99mTc-DPD bone scintigraphy with histological amyloid load in patients with ATTR cardiac amyloidosis.","authors":"Maria Ungericht, Valeria Groaz, Moritz Messner, Thomas Schuetz, Luca Brunelli, Marc-Michael Zaruba, Daniela Lener, Eva Stocker, Axel Bauer, Alexander Stephan Kroiss, Agnes Mayr, Christoph Röcken, Gerhard Poelzl","doi":"10.1080/13506129.2023.2239986","DOIUrl":"10.1080/13506129.2023.2239986","url":null,"abstract":"<p><strong>Background: </strong>The significance of measuring 99mTc-labelled-3,3-diphosphono-1,2-propanodicarboxylic acid (99mTc-DPD) in transthyretin (ATTR) cardiac amyloidosis has not been adequately studied. This single-centre observational study evaluated the correlation between 99mTc-DPD scintigraphy and histological amyloid load in endomyocardial biopsy (EMB).</p><p><strong>Methods: </strong>Twenty-eight patients with biopsy-proven ATTR amyloidosis and concomitantly available 99mTc-DPD scintigraphy were included. Visual Perugini scoring, and (semi-)quantitative analysis of cardiac 99mTc-DPD uptake by planar whole-body imaging and single photon emission computed tomography (SPECT/CT) using regions of interest (ROI) were performed. From this, heart-to-whole-body ratio (H/WB) and heart-to-contralateral-chest ratio (H/CL) were calculated. The histological amyloid load was quantified using two different staining methods.</p><p><strong>Results: </strong>Increased cardiac tracer uptake was documented in all patients (planar: ROImean 129 ± 37 cps; SPECT/CT: ROImean 369 ± 142 cps). Histological amyloid load (19 ± 13%) significantly correlated with Perugini score (<i>r</i> = 0.69, <i>p</i> < .001) as well as with cardiac 99mTc-DPD uptake (planar: <i>r</i> = 0.64, <i>p</i> < .001; H/WB: <i>r</i> = 0.50, <i>p</i> = .014; SPECT/CT: <i>r</i> = 0.53, <i>p</i> = .008; H/CL: <i>r</i> = 0.43, <i>p</i> = .037) (results are shown for correlations with Congo Red-staining).</p><p><strong>Conclusion: </strong>In ATTR, cardiac 99mTc-DPD uptake significantly correlated with histological amyloid load in EMB. Further studies are needed to implement thresholds in cardiac 99mTc-DPD uptake measurements for risk stratification and guidance of therapy.</p>","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9917681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-03DOI: 10.1080/13506129.2023.2263620
Abdirahman Wardhere, Dimitrios Bampatsias, Nowell Fine, Pablo Garcia-Pavia, Martha Grogan, Arnt V Kristen, Thibaud Damy, Yoshiki Sekijima, Mathew S Maurer
{"title":"Heterogeneous worldwide access and pricing of Tafamidis.","authors":"Abdirahman Wardhere, Dimitrios Bampatsias, Nowell Fine, Pablo Garcia-Pavia, Martha Grogan, Arnt V Kristen, Thibaud Damy, Yoshiki Sekijima, Mathew S Maurer","doi":"10.1080/13506129.2023.2263620","DOIUrl":"10.1080/13506129.2023.2263620","url":null,"abstract":"","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-07-26DOI: 10.1080/13506129.2023.2239987
Maria C Azevedo Coutinho, Nuno Cortez-Dias, Guilhermina Cantinho, Susana Gonçalves, Nelson Cunha, Tiago Rodrigues, Laura Santos, Isabel Conceição, João Agostinho, Fausto J Pinto
Background: Early diagnosis and prognostic stratification of cardiac transthyretin amyloidosis are crucial. Although 99mTc 3,3-diphosphono-1,2-propanedicarboxylic acid (DPD) scintigraphy is the preferred method for the non-invasive diagnosis, its accuracy appears to be limited in transthyretin amyloidosis protein (ATTR) V30M mutation. Furthermore, its prognostic value in this mutation is unknown. This study investigated the diagnostic value of DPD scintigraphy to detect ATTR cardiomyopathy in V30M mutation and explored its prognostic value regarding mortality.
Methods: A total of 288 ATTR V30M mutation carriers (median age: 46 years; 49% males) without myocardial thickening (defined as septal thickness ≥13mm) attributable to other causes and who underwent DPD scintigraphy were enrolled. ATTR cardiomyopathy was defined by septal thickness ≥13mm and at least one of the criteria: late heart-to-mediastinum (H/M) 123I-metaiodobenzylguanidine (MIBG) uptake ratio <1.60; electrical heart disease or biopsy-documented amyloidosis.
Results: ATTR cardiomyopathy was identified in 41 (14.2%) patients and cardiac DPD uptake in 34 (11.8%). During a mean follow-up of 33.6 ± 1.2 months, 16 patients died (5.6%). Mortality was 14 times higher in patients with ATTR cardiomyopathy, 13 times higher in those with DPD uptake and 10 times higher in those with late H/M MIBG <1.60. The combined assessment of septal thickness and cardiac DPD uptake improved risk stratification: patients without septal thickening and without DPD retention had an excellent prognosis while those who presented either or both of them had a significantly worse prognosis, with 5-year mortality rates ranging from 39.9 to 53.3%.
Conclusions: DPD scintigraphy is useful for prognostic stratification of ATTR V30M mutation carriers. Patients without septal thickening and no DPD uptake present the best prognosis compared to those with any signs of cardiac involvement.
{"title":"Diagnostic and prognostic contribution of DPD scintigraphy in transthyretin V30M cardiac amyloidosis.","authors":"Maria C Azevedo Coutinho, Nuno Cortez-Dias, Guilhermina Cantinho, Susana Gonçalves, Nelson Cunha, Tiago Rodrigues, Laura Santos, Isabel Conceição, João Agostinho, Fausto J Pinto","doi":"10.1080/13506129.2023.2239987","DOIUrl":"10.1080/13506129.2023.2239987","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis and prognostic stratification of cardiac transthyretin amyloidosis are crucial. Although <sup>99m</sup>Tc 3,3-diphosphono-1,2-propanedicarboxylic acid (DPD) scintigraphy is the preferred method for the non-invasive diagnosis, its accuracy appears to be limited in transthyretin amyloidosis protein (ATTR) V30M mutation. Furthermore, its prognostic value in this mutation is unknown. This study investigated the diagnostic value of DPD scintigraphy to detect ATTR cardiomyopathy in V30M mutation and explored its prognostic value regarding mortality.</p><p><strong>Methods: </strong>A total of 288 ATTR V30M mutation carriers (median age: 46 years; 49% males) without myocardial thickening (defined as septal thickness ≥13mm) attributable to other causes and who underwent DPD scintigraphy were enrolled. ATTR cardiomyopathy was defined by septal thickness ≥13mm and at least one of the criteria: late heart-to-mediastinum (H/M) <sup>123</sup>I-metaiodobenzylguanidine (MIBG) uptake ratio <1.60; electrical heart disease or biopsy-documented amyloidosis.</p><p><strong>Results: </strong>ATTR cardiomyopathy was identified in 41 (14.2%) patients and cardiac DPD uptake in 34 (11.8%). During a mean follow-up of 33.6 ± 1.2 months, 16 patients died (5.6%). Mortality was 14 times higher in patients with ATTR cardiomyopathy, 13 times higher in those with DPD uptake and 10 times higher in those with late H/M MIBG <1.60. The combined assessment of septal thickness and cardiac DPD uptake improved risk stratification: patients without septal thickening and without DPD retention had an excellent prognosis while those who presented either or both of them had a significantly worse prognosis, with 5-year mortality rates ranging from 39.9 to 53.3%.</p><p><strong>Conclusions: </strong>DPD scintigraphy is useful for prognostic stratification of ATTR V30M mutation carriers. Patients without septal thickening and no DPD uptake present the best prognosis compared to those with any signs of cardiac involvement.</p>","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9868164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-06DOI: 10.1080/13506129.2023.2267162
Crystal Lihong Yan, Nina Thakkar Rivera, James Hoffman
{"title":"Inappropriate use of technetium-99m pyrophosphate scanning for the evaluation of transthyretin amyloidosis.","authors":"Crystal Lihong Yan, Nina Thakkar Rivera, James Hoffman","doi":"10.1080/13506129.2023.2267162","DOIUrl":"10.1080/13506129.2023.2267162","url":null,"abstract":"","PeriodicalId":50964,"journal":{"name":"Amyloid-Journal of Protein Folding Disorders","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}