Background: Tc99m-pyrophosphate (Tc99m-PYP) scintigraphy has emerged as a diagnostic modality for transthyretin (TTR) cardiac amyloidosis (CA). We sought to examine the variability in test utilization across multiple centers in the US.
Methods: An electronic, web-based survey addressing specifics on Tc-99m PYP imaging was emailed to ASNC members, totaling 2785 recipients. Only one response per institution was allowed.
Results: Responses were collected from 101 centers between July 2 and July 27, 2015. Among the respondents, 24% performed Tc-99m PYP specifically for CA diagnosis. The most commonly used dose was 20 mCi (37%) and most centers (35%) imaged 1 hour after injection. Scans were most often interpreted by cardiologists (60%). Quantification of uptake was performed in 57% of institutions with almost half (43%) utilizing the heart-to-contralateral lung (H/CL) ratio.
Conclusions: This national survey shows relatively low penetrance and high variability in Tc99m-PYP scintigraphy for CA diagnosis highlighting the need for standardization.
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http://dx.doi.org/10.1007/s12350-016-0478-3 | DOI Listing |
Background: Diagnosis of cardiac amyloidosis (CA) is often missed or delayed due to confusion with other causes of increased left ventricular wall thickness. Conventional transthoracic echocardiographic measurements like global longitudinal strain (GLS) has shown promise in distinguishing CA, but with limited specificity. We conducted a study to investigate the performance of a computer vision detection algorithm in across multiple international sites.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
National Key Laboratory for Innovation and Transformation of Luobing Theory, Jinan, China.
Background: Cardiac amyloidosis (CA) is a challenging diagnosis, particularly when the classic signs, such as increased wall thickness in a non-dilated left ventricle (LV), are absent. This makes the diagnosis more difficult in patients with normal LV wall thickness. We present a case of CA without increased wall thickness and without the characteristic granular sparkling echotexture in a non-dilated LV.
View Article and Find Full Text PDFOpen Respir Arch
November 2024
Translational Research In Airway Diseases Group (TRIAD), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Can J Cardiol
January 2025
Brigham and Women's Hospital Amyloidosis Program and Section of Cardiology, Brigham and Women's Hospital, Boston MA 02115 USA; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
AF is a common arrhythmia in cardiomyopathy, particularly when congestive heart failure is present. The neurohormonal activation in congestive heart failure may trigger fibrotic and other changes in the left atrium and the atrial stretch associated with heart failure may induce further atrial pathology and/ or directly trigger AF (8). By the time that patients with AF develop extensive fibrosis, the arrhythmia has been shown to be associated with a greater difficulty in maintaining sinus rhythm despite attempted ablation procedures.
View Article and Find Full Text PDFIndian Pacing Electrophysiol J
January 2025
Royal Jubilee Hospital, Vancouver Island Health Authority, British Columbia, Canada.
Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle.
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