Diagnostic and prognostic value of right ventricle uptake at 99m-PYP scintigraphy in patients with ATTR cardiac amyloidosis

Abstract Funding Acknowledgements Type of funding sources: Private company. Main source(s): Pfizer. Introduction Bone-seeking tracers scintigraphy has assumed a central role in the diagnosis Amyloid Transthyretin Cardiac Amyloidosis (ATTR-CA) since it is currently only non-invasive imaging method capable accurately diagnosing ATTR-CA. It well known that right ventricle (RV) involvement associated with poor clinical prognosis patients heart failure. Non-invasive methods such as echocardiography and cardiac magnetic resonance have shown RV common related to outcomes. However, there paucity data regarding particular group ATTR - CA patients. Purpose The present study was primarily designed evaluate diagnostic incremental prognostic value uptake technetium-99m (99mTc) pyrophosphate (PYP) ATTR-CA Methods This prospective, observational, longitudinal clinical, laboratory obtained from for period 24 months. Only suggested by after ruling out monoclonal gammopathies were selected. Patients underwent 99mTc-PYP-scintigraphy myocardial confirmed on planar images SPECT/CT according Perugini visual score. primary outcome composite cardiovascular death due worsening failure or fatal arrhythmia, atrial fibrillation stroke. Results Ten subjects included August 2020 October 2022. Median age 72 years, all male 5 (50%) African American. 8 (80%) had hereditary 2 (20%) wild type. mild renal dysfunction NYHA Class II III observed 90% levels NT-pro-BNP troponin 1688,77 pg/ml (100–4545) 0,084 ng/ml (0,064–0,123), respectively. Left Ventricle Ejection Fraction 39,5 ± 7,86 (Simpson's) median interventricular septum thickness 16,1 2,56 mm. Regarding results bi-ventricular (BIV) 7 (70%). All grade 3 score left (LV) most pattern homogeneous diffuse In BIV 57% (grade 3), 29% 2) 14% 1) also (57%). Apex mid-apex patients, Three died during follow-up cardiogenic shock: two one without at 99m-Tc-PYP scintigraphy. No statically significant difference survival curve follow up. Conclusions prevalence bi-ventriclular 99m-Tc-PYP- high but not our study.