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Pattern of myocardial 99mTc-HMDP uptake and impact on myocardial function in patients with transthyretin cardiac amyloidosis

  • Original Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Aims

The purpose of the study was to describe the pattern of 99mTc-labeled phosphate agents myocardial uptake by scintigraphy and explore its impact on left ventricular (LV) functions in transthyretin cardiac amyloidosis (TTR-CA).

Methods

Fifty patients with TTR-CA underwent 99mTc- hydroxymethylene-diphosphonate (99mTc-HMDP) scintigraphy and echocardiography with measure of LV thickness, longitudinal strain (LS), systolic and diastolic functions. Cardiac retention by scintigraphy was assessed by visual scoring and the heart/whole body (H/WB) 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. Mean H/WB ratio was 12 ± 7. Myocardial 99mTc-HMDP uptake on segments 5, 6, 7, 8, 11, 12, 13, 14, 16, and 17 was correlated with H/WB ratio. Mean LVEF and global LS were 51 ± 10% and − 10 ± 3%, respectively. H/WB ratio was correlated with global LS (R = 0.408, P = .003), Ea (R = − 0.566, P < .001) and mean left ventricular wall thickness (R = 0.476, P < .001) but not with LVEF (R = − 0.109, P = .453). Segmental myocardial uptake was slightly correlated with segmental LS (R = 0.152, P < .001). H/WB ratio was not correlated with NT-proBNP levels (R = 0.219, P = .148) neither E/Ea ratio (R = 0.204, P = .184).

Conclusion

These findings show the relationship between bone tracer myocardial uptake and LV functions in patients with TTR cardiac amyloidosis.

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Abbreviations

99mTc-HMDP:

99mTc-hydroxymethylene-diphosphonate

H/WB:

Heart/whole body

IQR:

Inter-quartile range

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

LS:

Longitudinal strain

NT-proBNP:

N-terminal pro-hormone brain natriuretic peptide

TTR:

Transthyretin

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Toulouse Amyloidosis Research Network collaborators

Stanislas Faguer, MD, PhD, Dominique Chauveau, MD, PhD, Antoine Huart, MD, Joelle Guitard, MD, Pauline Bernadet Monrozies, MD (Department of Nephrology and Referral Center for Rare Diseases, University Hospital of Rangueil, Toulouse, France); Pascal Cintas, MD, PhD (Department of Neurology, Purpan University Hospital, Toulouse, France); Laurent Alric, MD, PhD (Department of Internal Medicine and Digestive Diseases, Purpan University Hospital, Toulouse, France); Daniel Adoue, MD, PhD, Laurent Sailler, MD, PhD, Léonardo Astudillo, MD (Department of Internal Medicine, Toulouse University Hospital, Toulouse, France); Bénédicte Puissant, MD (Immunology Laboratory, Toulouse University Hospital, Toulouse, France); Grégoire Prévot, MD (Department of Pneumology, Toulouse University Hospital, Toulouse, France); Magali Colombat, MD, PhD, Audrey Delas, MD (Department of Pathology, IUCT Oncopôle, Toulouse, France); Murielle Roussel, MD (Department of Hematology, Toulouse University Hospital, Toulouse, France); Eve Cariou, MD (Department of Cardiology, Rangueil University Hospital, Toulouse, France); Delphine Dupin-Deguine, MD.

Disclosure

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Cardiology, Rangueil University Hospital, Toulouse, France

    Sarah Pradel MD, Stéphanie Brun MD, Pauline Fournier MD, Yoan Lavie-Badie MD, Michel Galinier MD, PhD, Didier Carrié MD, PhD & Olivier Lairez MD, PhD

  2. Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France

    Sarah Pradel MD, Stéphanie Brun MD, Pierre Pascal MD, Pauline Fournier MD, Yoan Lavie-Badie MD, Michel Galinier MD, PhD, Didier Carrié MD, PhD, Isabelle Berry MD, PhD & Olivier Lairez MD, PhD

  3. Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France

    Gérard Victor MD, Pierre Pascal MD, Yoan Lavie-Badie MD, Isabelle Berry MD, PhD & Olivier Lairez MD, PhD

  4. Medical School of Rangueil, University Paul Sabatier, Toulouse, France

    Gérard Victor MD, Michel Galinier MD, PhD, Isabelle Berry MD, PhD & Olivier Lairez MD, PhD

  5. Department of Nephrology and Organ Transplantation, Rangueil University Hospital, Toulouse, France

    David Ribes MD

  6. Medical School of Purpan, University Paul Sabatier, Toulouse, France

    Didier Carrié MD, PhD

Authors
  1. Sarah Pradel MD
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  2. Stéphanie Brun MD
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  3. Gérard Victor MD
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  4. Pierre Pascal MD
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  5. Pauline Fournier MD
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  7. Yoan Lavie-Badie MD
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  8. Michel Galinier MD, PhD
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Consortia

the Toulouse Amyloidosis Research Network collaborators

  • Stanislas Faguer MD, PhD
  • , Pascal Cintas MD, PhD
  • , Laurent Alric MD, PhD
  • , Daniel Adoue MD, PhD
  • , Laurent Sailler MD, PhD
  • , Léonardo Astudillo MD
  • , Bénédicte Puissant MD
  • , Grégoire Prévot MD
  • , Dominique Chauveau MD, PhD
  • , Antoine Huart MD
  • , Magali Colombat MD, PhD
  • , Audrey Delas MD
  • , Joelle Guitard MD
  • , Pauline Bernadet Monrozies MD
  • , Murielle Roussel MD
  • , Eve Cariou MD
  •  & Delphine Dupin-Deguine MD

Corresponding author

Correspondence to Olivier Lairez MD, PhD.

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The collaborators for Toulouse Amyloidosis Research Network group are listed in “Acknowledgment”.

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Pradel, S., Brun, S., Victor, G. et al. Pattern of myocardial 99mTc-HMDP uptake and impact on myocardial function in patients with transthyretin cardiac amyloidosis. J. Nucl. Cardiol. 27, 96–105 (2020). https://doi.org/10.1007/s12350-018-1316-6

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  • DOI: https://doi.org/10.1007/s12350-018-1316-6

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