Heart failure & cardiomyopathiesCohort study
Clinical and Prognostic Implications of Right Ventricular Uptake on Bone Scintigraphy in Transthyretin Amyloid Cardiomyopathy
- Cohort study
- multicentre
- consecutive patients
Authors' conclusion
Diffuse RV uptake of bone tracer on SPECT imaging is associated with poor outcomes in patients with ATTR-CM and is an independent prognostic marker at diagnosis.
Study context
- Population
- Patients with ATTR-CM undergoing diagnostic bone tracer scintigraphy with single-photon emission computed tomography (SPECT), National Amyloidosis Centre and 4 Italian centres494 died
- Participants
- 1,422 patients
- Exposure
- Diffuse vs focal right ventricular (RV) uptake on bone scintigraphy SPECT
- Diffusen = 936
- Focaln = 486reference
- Outcome
- All-cause mortality
- Follow-up
- Median 34 months (IQR 21 to 50 months)
Main finding
As reported in the abstract
Hazard ratio
1.60
95% CI 1.26–2.04
P < 0.001
By group
Diffuse vs Focal
HR 1.60 (95% CI 1.26–2.04); P < 0.001
Observational data: associations, not effects.
Further findings
Perugini grade and survival
- Perugini grade not associated with survival (grade 2 vs grade 3)
- P = 0.27
Prognostic value of diffuse RV uptake by ATTR-CM type (subgroup)
- Maintained in wild-type ATTR-CM
- P < 0.001
- Maintained in hereditary ATTR-CM
- P = 0.02
- Maintained across each National Amyloidosis Centre stage
RV uptake with LV uptake on SPECT at diagnosis
- RV uptake accompanying LV uptake
- 100%
Original publication
Clinical and Prognostic Implications of Right Ventricular Uptake on Bone Scintigraphy in Transthyretin Amyloid Cardiomyopathy. Circulation. Published 8 February 2024. doi:10.1161/circulationaha.123.066524
Summarised from the published abstract; every number is checked against it