Imaging in Cardiac Amyloidosis

Abstract: A cause of heart failure with preserved ejection fraction is ATTR cardiac amyloidosis (Transthyretin cardiac amyloidosis). 99m Tc-Pyrophosphate (99m Tc- PYP) cardiac imaging is useful for detection of ATTR cardiac amyloidosis.Amyloid deposition in the heart can cause diastolic dysfunction, restrictive cardiomyopathy and congestive heart failure.Differential diagnosis between ATTR cardiac amyloidosis, and light chain–related amyloidosis (AL amyloidosis) are mandatory because these etiologies as well as other etiologies have differing clinical courses and management. Treatment of this type amyloidosis is differ from other causes of cardiomyopathies. Unfortunately, perfect and standard tests for diagnosis have limitations. However, myocardial 99mTc-PYP uptake in patients with ATTR cardiac amyloidosis has been described. It was able with a high sensitivity and specificity to differentiate it from AL amyloidosis as well as from the other nonamyloid heart failure. So 99mTc-PYP may have diagnostic and prognostic importance.