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A case of disappearing amyloid on technetium pyrophosphate scan

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Journal of Nuclear Cardiology Aims and scope

Abstract

Technetium-99mm pyrophosphate (Tc-PYP) scintigraphy is a highly accurate non-invasive method for the diagnosis of transthyretin (ATTR) cardiac amyloidosis. Prognosis for this disease is improved following treatment with the transthyretin (TTR) stabilizer tafamidis. Although tafamidis slows disease progression, its effects on myocardial amyloid and Tc-PYP uptake remain unclear. We present a patient with ATTR cardiac amyloidosis who had a strongly positive initial Tc-PYP scan, with a dramatic decrease in Tc-PYP uptake on repeat scan after 3 years of tafamidis treatment. However, myocardial biopsy showed persistent diffuse amyloid deposits. This case highlights the need for further studies regarding the utility of serial Tc-PYP scans in monitoring the progress of ATTR cardiomyopathy.

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This report did not receive any specific grant from any funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA

    Andy Wang MD

  2. Department of Cardiology, Westchester Medical Center, New York Medical College, 100 Woods Rd, Macy Pavilion, Valhalla, NY, 10595, USA

    Uzair Mahmood MD, Diwakar Jain MD, FACC, MASNC & Stephen Pan MD, MS

  3. Department of Pathology, Westchester Medical Center, New York Medical College, Valhalla, NY, USA

    Xiaoyu Tang MD, PhD

Authors
  1. Andy Wang MD
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  2. Uzair Mahmood MD
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  3. Xiaoyu Tang MD, PhD
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  4. Diwakar Jain MD, FACC, MASNC
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  5. Stephen Pan MD, MS
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Corresponding author

Correspondence to Diwakar Jain MD, FACC, MASNC.

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Andy Wang, Uzair Mahmood and Xiaoyu Tang: No disclosures. Diwakar Jain and Stephen Pan: Speakers’ Bureau, Pfizer Inc.

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Wang, A., Mahmood, U., Tang, X. et al. A case of disappearing amyloid on technetium pyrophosphate scan. J. Nucl. Cardiol. 30, 1986–1991 (2023). https://doi.org/10.1007/s12350-023-03316-1

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  • DOI: https://doi.org/10.1007/s12350-023-03316-1

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