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Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy

BACKGROUND: Transthyretin amyloidosis (ATTR) is an occasional incidental finding on bone scintigraphy. We studied its prognostic impact in elderly patients. METHODS: The study population consisted of 2000 patients aged over 70 years who underwent bone scintigraphies with clinical indications in thre...

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Autores principales: Suomalainen, Olli, Pilv, Jaagup, Loimaala, Antti, Mätzke, Sorjo, Heliö, Tiina, Uusitalo, Valtteri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9163012/
https://www.ncbi.nlm.nih.gov/pubmed/33094472
http://dx.doi.org/10.1007/s12350-020-02396-7
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author Suomalainen, Olli
Pilv, Jaagup
Loimaala, Antti
Mätzke, Sorjo
Heliö, Tiina
Uusitalo, Valtteri
author_facet Suomalainen, Olli
Pilv, Jaagup
Loimaala, Antti
Mätzke, Sorjo
Heliö, Tiina
Uusitalo, Valtteri
author_sort Suomalainen, Olli
collection PubMed
description BACKGROUND: Transthyretin amyloidosis (ATTR) is an occasional incidental finding on bone scintigraphy. We studied its prognostic impact in elderly patients. METHODS: The study population consisted of 2000 patients aged over 70 years who underwent bone scintigraphies with clinical indications in three nuclear medicine departments (Kymenlaakso, Jorvi and Meilahti hospitals) in Finland. All studies were performed using (99m)Technetium labeled hydroxymethylene diphosphonate (HMDP). ATTR was suspected in patients with ≥grade 2 Perugini grade uptake (grade 0-3). Heart-to-contralateral ratio (H/CL) of ≥ 1.30 was considered positive for ATTR. The overall and cardiovascular mortality were obtained from the Finnish National Statistical Service. RESULTS: There were a total of 1014 deaths (51%) and 177 cardiovascular deaths (9%) during median follow-up of 4 ± 2 years. ATTR was suspected in 69 patients (3.6%) of which 54 (2.7%) had grade 2 and 15 (.8%) had grade 3 uptake and in 47 patients (2.4%) by H/CL ratio. In multivariate analyses age, bone metastasis, H/CL ratio and grade 3 uptake were independent predictors of overall and cardiovascular mortality. Grade 2 uptake was a predictor of cardiovascular mortality. CONCLUSIONS: A suspected ATTR as an incidental finding on bone scintigraphy predicts elevated overall and cardiovascular mortality in elderly patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12350-020-02396-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-91630122022-06-05 Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy Suomalainen, Olli Pilv, Jaagup Loimaala, Antti Mätzke, Sorjo Heliö, Tiina Uusitalo, Valtteri J Nucl Cardiol Original Article BACKGROUND: Transthyretin amyloidosis (ATTR) is an occasional incidental finding on bone scintigraphy. We studied its prognostic impact in elderly patients. METHODS: The study population consisted of 2000 patients aged over 70 years who underwent bone scintigraphies with clinical indications in three nuclear medicine departments (Kymenlaakso, Jorvi and Meilahti hospitals) in Finland. All studies were performed using (99m)Technetium labeled hydroxymethylene diphosphonate (HMDP). ATTR was suspected in patients with ≥grade 2 Perugini grade uptake (grade 0-3). Heart-to-contralateral ratio (H/CL) of ≥ 1.30 was considered positive for ATTR. The overall and cardiovascular mortality were obtained from the Finnish National Statistical Service. RESULTS: There were a total of 1014 deaths (51%) and 177 cardiovascular deaths (9%) during median follow-up of 4 ± 2 years. ATTR was suspected in 69 patients (3.6%) of which 54 (2.7%) had grade 2 and 15 (.8%) had grade 3 uptake and in 47 patients (2.4%) by H/CL ratio. In multivariate analyses age, bone metastasis, H/CL ratio and grade 3 uptake were independent predictors of overall and cardiovascular mortality. Grade 2 uptake was a predictor of cardiovascular mortality. CONCLUSIONS: A suspected ATTR as an incidental finding on bone scintigraphy predicts elevated overall and cardiovascular mortality in elderly patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12350-020-02396-7) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-10-22 2022 /pmc/articles/PMC9163012/ /pubmed/33094472 http://dx.doi.org/10.1007/s12350-020-02396-7 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Suomalainen, Olli
Pilv, Jaagup
Loimaala, Antti
Mätzke, Sorjo
Heliö, Tiina
Uusitalo, Valtteri
Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
title Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
title_full Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
title_fullStr Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
title_full_unstemmed Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
title_short Prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
title_sort prognostic significance of incidental suspected transthyretin amyloidosis on routine bone scintigraphy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9163012/
https://www.ncbi.nlm.nih.gov/pubmed/33094472
http://dx.doi.org/10.1007/s12350-020-02396-7
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