Diagnostic and prognostic value of Technetium-99m pyrophosphate uptake quantitation for transthyretin cardiac amyloidosis.
Diagnostic and prognostic value of Technetium-99m pyrophosphate uptake quantitation for transthyretin cardiac amyloidosis.
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DOI：
10.1007/s12350-021-02563-4
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Slomka PJ
中科院分区：
文献类型：
--
作者：
Miller RJH;Cadet S;Mah D;Pournazari P;Chan D;Fine NM;Berman DS;Slomka PJ
99mTc-焦磷酸成像已成为诊断转甲状腺素蛋白心脏淀粉样变性（ATTR-CM）的重要非侵入性方法。 SPECT 图像上 99mTc-焦磷酸盐活性的定量可能是 ATTR-CM 疾病负担的标志。我们评估了 99mTc-焦磷酸定量的诊断准确性和临床意义。因疑似 ATTR-CM 而接受 99mTc-焦磷酸盐成像的患者也被纳入其中。使用 SPECT 图像，使用心脏焦磷酸盐活性 (CPA) 和受累体积 (VOI) 计算心肌中的放射性示踪剂活性，并使用源自 LVBP 活性的异常活性阈值。使用受试者工作特征曲线下面积（AUC）评估诊断准确性。总共确定了 124 名患者，平均年龄 73.9 ± 11.4 岁，其中 43 名 (34.7%) 患者诊断为 ATTR-CM。 CPA 的诊断准确性最高（AUC 0.996，95% CI 0.987 – 1.00），并且显着高于 Perugini 评分（AUC 0.952，p=0.016）。在 ATTR-CM 患者中，CPA 与左心室射血分数降低（调整后优势比 1.28，p=0.035）和心力衰竭住院（调整后风险比 1.29，p=0.006）相关。使用 CPA 或 VOI 定量评估心肌放射性示踪剂活性对于 ATTR-CM 具有很高的诊断准确性。这两种措施都是潜在的非侵入性标志物，可追踪疾病进展或治疗反应。
99mTc-pyrophosphate imaging has emerged as an important non-invasive method to diagnose transthyretin cardiac amyloidosis (ATTR-CM). Quantitation of 99mTc-pyrophosphate activity, on SPECT images, could be a marker of ATTR-CM disease burden. We assessed the diagnostic accuracy and clinical significance of 99mTc-pyrophosphate quantitation. Patients who underwent 99mTc-pyrophosphate imaging for suspected ATTR-CM were included. Using SPECT images, radiotracer activity in the myocardium was calculated using cardiac pyrophosphate activity (CPA) and volume of involvement (VOI), with thresholds for abnormal activity derived from LVBP activity. Diagnostic accuracy was assessed using area under the receiver operating characteristic curve (AUC). In total, 124 patients were identified, mean age 73.9 ± 11.4, with ATTR-CM diagnosed in 43 (34.7%) patients. CPA had the highest diagnostic accuracy (AUC 0.996, 95% CI 0.987 – 1.00), and was significantly higher compared to the Perugini score (AUC 0.952, p=0.016). In patients with ATTR-CM, CPA was associated with reduced left ventricular ejection fraction (adjusted odds ratio 1.28, p=0.035) and heart failure hospitalizations (adjusted hazard ratio 1.29, p=0.006). Quantitative assessment of myocardial radiotracer activity with CPA or VOI have high diagnostic accuracy for ATTR-CM. Both measures are potential non-invasive markers to follow progression of disease or response to therapy.
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影响因子：
14
作者：
Scully, Paul R.;Morris, Elizabeth;Menezes, Leon J.
通讯作者：
Menezes, Leon J.
影响因子：
7.5
作者：
Masri, Ahmad;Bukhari, Syed;Soman, Prem
通讯作者：
Soman, Prem
影响因子：
37.8
作者：
Gillmore, Julian D.;Maurer, Mathew S.;Hawkins, Philip N.
通讯作者：
Hawkins, Philip N.
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
DOI：
10.1161/circimaging.112.000132
发表时间：
2013-03-01
期刊：
Circulation. Cardiovascular imaging
影响因子：
--
作者：
Bokhari S;Castaño A;Pozniakoff T;Deslisle S;Latif F;Maurer MS
通讯作者：
Maurer MS