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Tc-99m labelled bone scintigraphy in suspected cardiac amyloidosis.
Rauf, Muhammad Umaid; Hawkins, Philip N; Cappelli, Francesco; Perfetto, Federico; Zampieri, Mattia; Argiro, Alessia; Petrie, Aviva; Law, Steven; Porcari, Aldostefano; Razvi, Yousuf; Bomsztyk, Joshua; Ravichandran, Sriram; Ioannou, Adam; Patel, Rishi; Starr, Neasa; Hutt, David F; Mahmood, Shameem; Wisniowski, Brendan; Martinez-Naharro, Ana; Venneri, Lucia; Whelan, Carol; Roczenio, Dorota; Gilbertson, Janet; Lachmann, Helen J; Wechalekar, Ashutosh D; Rapezzi, Claudio; Serenelli, Matteo; Massa, Paolo; Caponetti, Angelo Giuseppe; Ponziani, Alberto; Accietto, Antonella; Giovannetti, Alessandro; Saturi, Giulia; Sguazzotti, Maurizio; Gagliardi, Christian; Biagini, Elena; Longhi, Simone; Fontana, Marianna; Gillmore, Julian D.
Afiliación
  • Rauf MU; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Hawkins PN; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Cappelli F; Tuscan Amyloid Referral Centre, Careggi University Hospital, Florence, Italy.
  • Perfetto F; Tuscan Amyloid Referral Centre, Careggi University Hospital, Florence, Italy.
  • Zampieri M; Tuscan Amyloid Referral Centre, Careggi University Hospital, Florence, Italy.
  • Argiro A; Tuscan Amyloid Referral Centre, Careggi University Hospital, Florence, Italy.
  • Petrie A; Eastman Dental Institute, University College London (UCL), London, UK.
  • Law S; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Porcari A; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Razvi Y; Centre for Diagnosis and Treatment of Cardiomyopathies, Department of Cardiovascular, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Italy.
  • Bomsztyk J; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Ravichandran S; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Ioannou A; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Patel R; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Starr N; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Hutt DF; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Mahmood S; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Wisniowski B; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Martinez-Naharro A; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Venneri L; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Whelan C; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Roczenio D; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Gilbertson J; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Lachmann HJ; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Wechalekar AD; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Rapezzi C; National Amyloidosis Centre, University College London, Royal Free Campus, Rowland Hill Street, NW3 2PF London, UK.
  • Serenelli M; Cardiologic Centre, University of Ferrara, Italy.
  • Massa P; Maria Cecilia Hospital, GVM Care & Research, Cotignola (Ravenna), Italy.
  • Caponetti AG; Cardiologic Centre, Azienda Ospedaliero Universitaria di Ferrara, Italy.
  • Ponziani A; Cardiology Unit, Department of Cardiac Thoracic and Vascular, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Accietto A; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.
  • Giovannetti A; Cardiology Unit, Department of Cardiac Thoracic and Vascular, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Saturi G; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.
  • Sguazzotti M; Cardiology Unit, Department of Cardiac Thoracic and Vascular, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Gagliardi C; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.
  • Biagini E; Cardiology Unit, Department of Cardiac Thoracic and Vascular, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Longhi S; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.
  • Fontana M; Cardiology Unit, Department of Cardiac Thoracic and Vascular, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
  • Gillmore JD; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Italy.
Eur Heart J ; 44(24): 2187-2198, 2023 06 25.
Article en En | MEDLINE | ID: mdl-36946431
AIMS: To perform evaluation of widely embraced bone scintigraphy-based non-biopsy diagnostic criteria (NBDC) for ATTR amyloid cardiomyopathy (ATTR-CM) in clinical practice, and to refine serum free light chain (sFLC) ratio cut-offs that reliably exclude monoclonal gammopathy (MG) in chronic kidney disease. METHODS AND RESULTS: A multi-national retrospective study of 3354 patients with suspected or histologically proven cardiac amyloidosis (CA) referred to specialist centres from 2015 to 2021; evaluations included radionuclide bone scintigraphy, serum and urine immunofixation, sFLC assay, eGFR measurement and echocardiography. Seventy-nine percent (1636/2080) of patients with Perugini grade 2 or 3 radionuclide scans fulfilled NBDC for ATTR-CM through absence of a serum or urine monoclonal protein on immunofixation together with a sFLC ratio falling within revised cut-offs incorporating eGFR; 403 of these patients had amyloid on biopsy, all of which were ATTR type, and their survival was comparable to non-biopsied ATTR-CM patients (p = 0.10). Grade 0 radionuclide scans were present in 1091 patients, of whom 284 (26%) had CA, confirmed as AL type (AL-CA) in 276 (97%) and as ATTR-CM in only one case with an extremely rare TTR variant. Among 183 patients with grade 1 radionuclide scans, 122 had MG of whom 106 (87%) had AL-CA; 60/61 (98%) without MG had ATTR-CM. CONCLUSION: The NBDC for ATTR-CM are highly specific [97% (95% CI 0.91-0.99)] in clinical setting, and diagnostic performance was further refined here using new cut-offs for sFLC ratio in patients with CKD. A grade 0 radionuclide scan all but excludes ATTR-CM but occurs in most patients with AL-CA. Grade 1 scans in patients with CA and no MG are strongly suggestive of early ATTR-type, but require urgent histologic corroboration.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuropatías Amiloides Familiares / Cardiomiopatías Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Eur Heart J Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuropatías Amiloides Familiares / Cardiomiopatías Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: Eur Heart J Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido