99mTechnetium ‐pyrophosphate scintigraphy: a practical guide for early diagnosis of transthyretin amyloid cardiomyopathy

AbstractTransthyretin amyloid cardiomyopathy (ATTR-CM) is caused by the cardiac deposition of insoluble amyloid fibrils formed by misfolded transthyretin proteins and is associated with various cardiac symptoms, such as progressive heart failure, conduction disturbance, and arrhythmia. The implementation of99mtechnetium (99mTc)-labelled bone radiotracer scintigraphy for diagnosing ATTR-CM has enabled accurate diagnosis of the disease with high sensitivity and specificity and positioned this diagnostic modality as an integral part of disease diagnostic algorithms. In 2020,99mTc-pyrophosphate scintigraphy received exceptional approval for Japanese national health insurance reimbursement as a diagnostic method of ATTR-CM. Nevertheless, the utility of99mTc-labelled bone radiotracer scintigraphy and the importance of an early diagnosis of suspected ATTR-CM using this technique have yet to be internalized as common practice by general cardiologists, and guidance on daily clinical scenarios to consider this technique for a diagnosis of suspected ATTR-CM is warranted. In this review, we discuss the utility of99mTc-labelled bone radiotracer scintigraphy for the early diagnosis of ATTR-CM based on published literature and the outcomes of an advisory board meeting. This review also discusses clinical scenarios that could support early diagnosis of suspected ATTR-CM as well as common pitfalls, correct implementation, and future perspectives of99mTc-labelled bone radiotracer scintigraphy ...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Review Source Type: research