title: Quantitative Comparison Between Amyloid Deposition Detected by (99m)Tc-Diphosphonate Imaging and Myocardial Deformation Evaluated by Strain Echocardiography in Transthyretin-Related Cardiac Amyloidosis.
abstract: BACKGROUND
  Management of cardiac amyloidosis (CA) is related to amyloid deposition. Our aim was to assess the effect of amyloid deposition on myocardial function.
  
  
  RESULTS
  Twenty-eight patients with transthyretin mutation and a group of 14 controls underwent echocardiography to quantify left ventricular (LV) dimensions, function, and global (G) longitudinal (L), radial (R) and circumferential (C) strain (S). (99m)Tc-3,3-diphosphono-1,2-propanodicarboxylic-acid-scintigraphy ((99m)Tc-DPD) was used to quantify CA. (99m)Tc-DPD revealed accumulation in 14/28 patients (CA group) and no accumulation (no-CA group) in 14. Cardiac accumulation was lower-than-bone uptake in 5 (mild-CA group) and higher-than-bone uptake in 9 (severe-CA group). Ejection fraction was similar among groups. GLS was lower (P<0.001) in the severe-CA group (-12.2±4.5) with respect to the no-CA group (-19.3±3.0) and to the control group (-20.9±2.5). Conversely, GCS and GRS were lower (P<0.05) in the mild-CA group (-10.8±4.1 and 9.5±5.7, respectively) with respect to the severe-CA group (-18.9±5.1 and 23.9±6.3 respectively), no-CA group (-19.2±4.1 and 28.4±10.2, respectively) and the control group (-23.9±4.4 and 29.9±8.7, respectively). A correlation was found between the scintigraphic heart retention index (HRI) and LV septal thickness (ρ=0.72), E/E' (ρ=0.46) and GLS (ρ=-0.40).
  
  
  CONCLUSIONS
  Myocardial deformation is impaired in a different stage of CA. The (99m)Tc-DPD HRI correlated well with morphologic, diastolic and strain abnormalities. (Circ J 2016; 80: 1998-2003).
authors.affiliation: Clinical and Experimental Medicine Department, Cardiology Unit, University of Messina, AOU "Policlinico G. Martino"
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.forename: Fabio
authors.initials: F
authors.lastname: Minutoli
authors.forename: Paolo
authors.initials: P
authors.lastname: Piaggi
authors.forename: Matteo
authors.initials: M
authors.lastname: Casale
authors.forename: Anna
authors.initials: A
authors.lastname: Mazzeo
authors.forename: Concetta
authors.initials: C
authors.lastname: Zito
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Oreto
authors.forename: Sergio
authors.initials: S
authors.lastname: Baldari
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vita
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pingitore
authors.forename: Bijoy K
authors.initials: BK
authors.lastname: Khandheria
authors.forename: Scipione
authors.initials: S
authors.lastname: Carerj
mesh_terms: D000328:Adult; D000682:Amyloid / Q000378:metabolism*; D028227:Amyloid Neuropathies, Familial / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D013669:Technetium Tc 99m Medronate / Q000008:administration & dosage* / Q000493:pharmacokinetics; D014055:Tomography, Emission-Computed
chemical_list: D000682:Amyloid; D013669:Technetium Tc 99m Medronate