Prognostic Value of Tc-99m-HMDP Scintigraphy in Elderly Patients With Chronic Heart Failure

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Uusitalo , V , Suomalainen , O , Loimaala , A , Mätzke , S & Heliö , T 2022 , ' Prognostic Value of Tc-99m-HMDP Scintigraphy in Elderly Patients With Chronic Heart Failure ' , Heart, Lung & Circulation (Print) , vol. 31 , no. 5 , pp. 629-637 .

Title: Prognostic Value of Tc-99m-HMDP Scintigraphy in Elderly Patients With Chronic Heart Failure
Author: Uusitalo, Valtteri; Suomalainen, Olli; Loimaala, Antti; Mätzke, Sorjo; Heliö, Tiina
Contributor organization: HUS Medical Imaging Center
University of Helsinki
Department of Diagnostics and Therapeutics
HUS Heart and Lung Center
Department of Medicine
Date: 2022-05
Language: eng
Number of pages: 9
Belongs to series: Heart, Lung & Circulation (Print)
ISSN: 1443-9506
Abstract: Background This study evaluated the prevalence and prognostic significance of cardiac transthyretin amyloidosis (ATTR) diagnosed using Tc-99m- hydroxymethylene-diphosphonate (Tc-99m-HMDP) scintigraphy in an elderly heart failure population. Methods This retrospective study included 335 patients aged >70 years with heart failure and who underwent Tc-99m-HMDP scintigraphy due to non-cardiac reasons in three imaging centres in Finland (Kymenlaakso Central Hospital, Jorvi Central Hospital, and Meilahti University Hospital). A Perugini grade >= 2 and heart-to-contralateral ratio (H/CL) of >= 1.30 were considered positive for cardiac ATTR. The overall and cardiovascular mortality were obtained from the national statistical service (Statistics Finland). Results There were 234 deaths, of which 70 were classified as being due to cardiovascular causes during a median follow-up of 1 (1-3) year. Transthyretin amyloidosis was diagnosed in 22 patients (6.6%) using visual analysis and 17 patients using the H/CL ratio (5.1%). Patients with ATTR were older (85 +/- 5 vs 80 +/- 5 yrs; p=0.002) and had higher N-terminal pro-brain natriuretic peptide (NT-ProBNP) levels (1,451 [813-3,799] vs 6,192 [2,030-8,833] ng/L; p=0.02). Age, bone metastases, and glomerular filtration rate were independent predictors of overall mortality in multivariable analysis. Age, glomerular filtration rate, >= grade 2 visual cardiac uptake, and H/CL ratio were independent predictors of cardiovascular mortality. Conclusions Cardiac uptake suggestive of ATTR was found in 5% of elderly patients with chronic heart failure. The presence of cardiac uptake on bone scintigraphy did not convey independent prognostic value on overall mortality but was independently associated with cardiovascular mortality.
Subject: Amyloidosis
Heart failure
Bone scintigraphy
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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