Cargando…

Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy

Aims: There has been a paradigm shift in diagnosis of cardiac transthyretin amyloidosis (ATTR) with non-invasive techniques including technetium-99m 3,3-diphosphono-1,2-propanodicarboxylic acid ((99m)Tc-DPD) bone scintigraphy. We evaluated structural and functional biventricular alterations by trans...

Descripción completa

Detalles Bibliográficos
Autores principales: Harapoz, Mehmet, Evans, Scott, Geenty, Paul, Kwok, Fiona, Stewart, Graeme, Taylor, Mark S., Farlow, David, Thomas, Liza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553935/
https://www.ncbi.nlm.nih.gov/pubmed/34722650
http://dx.doi.org/10.3389/fcvm.2021.663929
_version_ 1784591682218491904
author Harapoz, Mehmet
Evans, Scott
Geenty, Paul
Kwok, Fiona
Stewart, Graeme
Taylor, Mark S.
Farlow, David
Thomas, Liza
author_facet Harapoz, Mehmet
Evans, Scott
Geenty, Paul
Kwok, Fiona
Stewart, Graeme
Taylor, Mark S.
Farlow, David
Thomas, Liza
author_sort Harapoz, Mehmet
collection PubMed
description Aims: There has been a paradigm shift in diagnosis of cardiac transthyretin amyloidosis (ATTR) with non-invasive techniques including technetium-99m 3,3-diphosphono-1,2-propanodicarboxylic acid ((99m)Tc-DPD) bone scintigraphy. We evaluated structural and functional biventricular alterations by transthoracic echocardiography (TTE) and determined the correlation with (99m)Tc-DPD tracer uptake in ATTR. Materials and Methods: ATTR patients (wild-type, hereditary or asymptomatic transthyretin [TTR] variant carriers) with (99m)Tc-DPD and TTE were selected; (99m)Tc-DPD uptake was analyzed quantitatively. TTE assessment of left ventricle (LV) and right ventricle (RV) parameters was performed. Results: Forty ATTR patients (wild-type n = 17; hereditary ATTR and TTR variant carriers n = 23; median age 68.8 ± 22 years) were included. TTE parameters displaying good correlation with (99m)Tc-DPD tracer uptake included LV average wall thickness (r = 0.837), LV indexed mass (LVMI; r = 0.802), RV wall thickness (r = 0.610), average e' (r = −0.830), E/e' ratio (r = 0.786), LV global longitudinal strain (GLS; r = 0.714) and RV GLS (r = 0.632; p < 0.001 for all). Hereditary ATTR and TTR variant carriers without cardiac tracer uptake had normal echocardiographic parameters. Receiver operating characteristic curves demonstrated strong diagnostic accuracies for structural (LV wall thickness, LVMI and RV wall thickness; area under the curve (AUC) of 0.96 for all) and functional (LV and RV GLS; AUC of 0.86 and 0.88, respectively) parameters. Conclusion: Good correlations between TTE biventricular structural and functional parameters were demonstrated with quantitative (99m)Tc-DPD uptake. Echocardiography may potentially assume a significant role in longitudinal follow-up for monitoring disease progression and for evaluating treatment response.
format Online
Article
Text
id pubmed-8553935
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-85539352021-10-30 Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy Harapoz, Mehmet Evans, Scott Geenty, Paul Kwok, Fiona Stewart, Graeme Taylor, Mark S. Farlow, David Thomas, Liza Front Cardiovasc Med Cardiovascular Medicine Aims: There has been a paradigm shift in diagnosis of cardiac transthyretin amyloidosis (ATTR) with non-invasive techniques including technetium-99m 3,3-diphosphono-1,2-propanodicarboxylic acid ((99m)Tc-DPD) bone scintigraphy. We evaluated structural and functional biventricular alterations by transthoracic echocardiography (TTE) and determined the correlation with (99m)Tc-DPD tracer uptake in ATTR. Materials and Methods: ATTR patients (wild-type, hereditary or asymptomatic transthyretin [TTR] variant carriers) with (99m)Tc-DPD and TTE were selected; (99m)Tc-DPD uptake was analyzed quantitatively. TTE assessment of left ventricle (LV) and right ventricle (RV) parameters was performed. Results: Forty ATTR patients (wild-type n = 17; hereditary ATTR and TTR variant carriers n = 23; median age 68.8 ± 22 years) were included. TTE parameters displaying good correlation with (99m)Tc-DPD tracer uptake included LV average wall thickness (r = 0.837), LV indexed mass (LVMI; r = 0.802), RV wall thickness (r = 0.610), average e' (r = −0.830), E/e' ratio (r = 0.786), LV global longitudinal strain (GLS; r = 0.714) and RV GLS (r = 0.632; p < 0.001 for all). Hereditary ATTR and TTR variant carriers without cardiac tracer uptake had normal echocardiographic parameters. Receiver operating characteristic curves demonstrated strong diagnostic accuracies for structural (LV wall thickness, LVMI and RV wall thickness; area under the curve (AUC) of 0.96 for all) and functional (LV and RV GLS; AUC of 0.86 and 0.88, respectively) parameters. Conclusion: Good correlations between TTE biventricular structural and functional parameters were demonstrated with quantitative (99m)Tc-DPD uptake. Echocardiography may potentially assume a significant role in longitudinal follow-up for monitoring disease progression and for evaluating treatment response. Frontiers Media S.A. 2021-10-15 /pmc/articles/PMC8553935/ /pubmed/34722650 http://dx.doi.org/10.3389/fcvm.2021.663929 Text en Copyright © 2021 Harapoz, Evans, Geenty, Kwok, Stewart, Taylor, Farlow and Thomas. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Harapoz, Mehmet
Evans, Scott
Geenty, Paul
Kwok, Fiona
Stewart, Graeme
Taylor, Mark S.
Farlow, David
Thomas, Liza
Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy
title Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy
title_full Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy
title_fullStr Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy
title_full_unstemmed Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy
title_short Correlation Between Quantitative Uptake of (99m)TC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy
title_sort correlation between quantitative uptake of (99m)tc-dpd and echocardiographic parameters in cardiac attr: a novel follow-up strategy
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553935/
https://www.ncbi.nlm.nih.gov/pubmed/34722650
http://dx.doi.org/10.3389/fcvm.2021.663929
work_keys_str_mv AT harapozmehmet correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT evansscott correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT geentypaul correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT kwokfiona correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT stewartgraeme correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT taylormarks correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT farlowdavid correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy
AT thomasliza correlationbetweenquantitativeuptakeof99mtcdpdandechocardiographicparametersincardiacattranovelfollowupstrategy