心脏闪烁扫描和超声心动图评估诊断转甲状腺素蛋白心脏淀粉样变性,The International Journal of Cardiovascular Imaging

目的是评估超声心动图和[ 99 mTc]Tc-DPD闪烁扫描在淀粉样心肌病（CM）检测中的诊断效果，并定义潜在的预后超声心动图参数。回顾性研究了 2016 年至 2021 年的 133 名患者，平均年龄为 80.2 ± 7.5 岁。最终诊断是根据国际共识确定的。患者接受了经胸超声心动图 (TTE) 和 [ 99 mTc]Tc-DPD 闪烁扫描；计算 RWT、E/e、LS、TAPSE、SAB 和 IWT 分数。所有 ATTR-CM 患者均分为 3 个预后阶段，并与 Perugini 分级和超声心动图参数进行比较。85 例 (63.9%) 确诊为 CM，76 例 (57.1%) ATTR-CM 和 9 例 (6.8%) AL-CM。计算[ 99 mTc]Tc-DPD显像和超声心动图的诊断率，心肌显像的敏感性为90.7%，特异性为100%，PPV为100%，NPV为87.2%，而心肌显像为74.6%、62.5%，超声心动图中75.6%、61.2%。根据IWT评分，大多数患者属于中间组；33 名学生的学习成绩为 2-3 级。将Perugini评分与IWT（p：0.02）和SAB（p：0.03）进行比较时获得了显着结果；以及生物标志物阶段与 LVEF (p: 0.028)、E/e´ (p: 0.001) 和 GLS% (p: 0.022) 之间的差异。[ 99 mTc]Tc-DPD 闪烁扫描在诊断 CA 方面具有优越性。SAB 可能是早期诊断阶段最可靠的参数，与 Perugini 2 级和 3 级有很强的相关性。

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The aim is to evaluate the diagnostic yield of echocardiography and [99mTc]Tc-DPD scintigraphy in the detection of amyloid cardiomyopathy (CM) and define potential prognostic echocardiographic parameters. 133 patients were retrospectively studied, from 2016 to 2021, with a mean age of 80.2 ± 7.5 years. The final diagnosis was established according to international consensus. Patients had a transthoracic echocardiogram (TTE) and [99mTc]Tc-DPD scintigraphy; RWT, E/e, LS, TAPSE, SAB, and IWT scores were calculated. All patients with ATTR-CM were classified into 3 prognostic stages and were compared with Perugini grades and echocardiographic parameters. CM was confirmed in 85 cases (63.9%), 76 (57.1%) ATTR-CM, and 9 (6.8%) AL-CM. The diagnostic yield of [99mTc]Tc-DPD scintigraphy and echocardiography were calculated, with a sensitivity of 90.7%, specificity of 100%, PPV of 100%, and NPV of 87.2% in myocardial scintigraphy, versus 74.6%, 62.5%, 75.6%, 61.2% in the echocardiogram. According to the IWT score, most patients were classified in the intermediate group; 33 presented with grade 2–3 uptakes. Significant results were obtained when comparing Perugini score with IWT (p: 0.02) and SAB (p: 0.03); and between biomarkers stages and LVEF (p: 0.028), E/e´ (p: 0.001), and GLS% (p: 0.022). [99mTc]Tc-DPD scintigraphy is superior in diagnosing CA. SAB could be the most reliable parameter in an early diagnostic phase, showing a strong correlation with Perugini grades 2 and 3.