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Echocardiography and 99mTc-DPD scintigraphy on cardiac amyloidosis investigation
Session:
Posters 3 - Écran 9 - Imagiologia Cardiovascular
Speaker:
CELIA DOMINGUES
Congress:
CPC 2019
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.3 Myocardial Disease – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Célia Domingues; Maria João Vidigal Ferreira; Hélder Martins; Patrícia M. Alves; J Almeida; Ana Vera Marinho; Maria João Cunha; Gracinda Costa; Lino Gonçalves
Abstract
<p>Background: The uptake of bone-seeking radiotracers in the amyloid heart is well recognized. 99<sup>m</sup>Tc-DPD has been shown to be highly sensitive for cardiac transthyretin (ATTR) amyloid. With the ageing population, restrictive/hypertrophic myocardiopathy pattern with heart failure and cardiac amyloidosis increases.</p> <p>Objectives: The purpose of this study was to find echocardiography and clinical predictors of 99mTc-DPD uptake on cardiac scintigraphy of patients under cardiac amyloidosis investigation.</p> <p>Results: Thirteen patients in whom cardiac scintigraphy with 99mTc-DPD was performed were also evaluated through echocardiography. The patients had a mean age of 74.0 ± 14 years and 69% (n=9) were males. Visual moderate to severemyocardial uptake of the tracer was presented in 46% (n=6) patients.</p> <p>The uptake of 99mTc-DPD presents direct correlation with permanent atrial flutter/fibrillation (AF) (r=0,69; p=0,09) and with right atria area (RAA)(r=0,62; p=0,02) and inversely correlates with systolic tissue velocity mapping of right ventricle (S’RV) (r=-0,89; p=0,02). No correlation was found with LVEF (r=0,25; p=0,41), thicker of LV wall (r= 0,23; p=0,45), E/A pattern of mitral flow (r=0,30; p=0,50), TAPSE of RV (r=-0,31;p=0,32) or with indexed left atrial volume (r=0,39; p=0,21).</p> <p>On this study the presence of at least 2 of 3 factors: S’VD<10 cm/s, presence of permanent AF and RAA > 20cm<sup>2</sup>, can predict with 83% sensitivity and 86% of specificity uptake of cardiac 99mTc-DPD (AUC 0,85; p=0,04; 95% CI 0,61-1,0) which seems to point out the relation between tracer uptake and a severe pattern of restrictive behavior of the myocardium.</p> <p>Conclusion: With ageing population and increase of suspicion of cardiac amyloidosis, echocardiography is particularly useful on daily practice. A larger prospective study is necessary to verify these results.</p>
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