Impact of cardiac 99mTc-HMDP uptake on myocardial function and left ventricular filling pressure in patients with transthyretin amyloidosis - 11/05/17
Résumé |
Background |
Pathophysiology of 99mTc-labeled phosphate agents cardiac uptake by scintigraphy in transthyretin-related (TTR) amyloidosis remains unclear. The impact of cardiac uptake on cardiac function is unknown. The aim of this study was to explore the pattern of 99mTc-labeled phosphate agents cardiac uptake by scintigraphy and its impact on left ventricular (LV) functions assessed by echocardiography.
Methods |
Fifty patients with TTR cardiac amyloidosis underwent 99mTc- hydroxymethylene-diphosphonate (99mTc-HMDP) scintigraphy and echocardiography with measure of LV morphology, longitudinal strain (LS), systolic and diastolic functions. Cardiac retention by scintigraphy was assessed by visual scoring and the heart/whole body (H/B) ratio was calculated by dividing counts in the heart by counts in late whole body images.
Results |
The mean population age was 79±10 years. Most of the patients (88%) were male. Visual score was 2 and 3 for 6 (12%) and 44 (88%) patients, respectively. Mean H/WB ratio was 12±7. Mean LV ejection fraction and global LS were 51±10% and -10±3%, respectively. H/WB ratio was correlated with global LS (R=0.408, P=0.003), Ea (R=-0.566, P<0.001) and mean left ventricular wall thickness (R=0.476, P<0.001) but not with LV ejection fraction (R=-0.109, P=0.453). Segmental myocardial uptake normalized by H/WB ratio was correlated with segmental LS (n=850 segments, R=0.162, P<0.001). H/WB ratio was not correlated with NT-proBNP levels (R=0.219, P=0.148) neither E/Ea ratio (R=0.204, P=0.184).
Conclusion |
In patients with TTR cardiac amyloidosis, myocardial uptake by 99mTc-HMDP scintigraphy is correlated with decrease of myocardial LS.
Le texte complet de cet article est disponible en PDF.Keywords : 99mTc-HDP, Amylose, Cardiologie
Plan
Vol 41 - N° 3
P. 149 - mai 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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