Heart failure & cardiomyopathiesCross-sectional study
Early Diagnosis of ATTR-CM Using Carpal Tunnel Biopsy Examination
- Cross-sectional study
- prospective
- multicentre
Authors' conclusion
Transthyretin amyloid (ATTR) is commonly present in the tenosynovium and transverse carpal ligaments of older people with carpal tunnel syndrome, and more than one quarter of whom have ATTR cardiac amyloid infiltration that is readily identifiable using bone scintigraphy.
Study context
- Population
- Unselected patients >50 years undergoing carpal tunnel decompression, UK; no existing amyloidosis diagnosis315 women
- Participants
- 555 patients
- Outcome
- Amyloid on carpal tunnel biopsy and myocardial amyloid (ATTR-CM) on Tc-DPD scintigraphy in biopsy-positive patients
Main finding
As reported in the abstract
- Amyloid identified on carpal tunnel biopsy
- 216 (39%)
- Amyloid on biopsy, male patients
- 51%
- Amyloid on biopsy, female patients
- 30%
- Tenosynovial vs transverse carpal ligament biopsies positive
- 82.6% vs 70.2%; P < 0.001
- Biopsy-positive patients assenting to cardiac assessment
- 116
- Myocardial amyloid on Tc-DPD scintigraphy
- 32 of 116 (28%)
- Perugini grade 2 uptake (significant ATTR-CM, disease-modifying therapy started)
- 10
- Male among DPD-positive
- 26
Observational data: associations, not effects.
Further findings
Unsuspected systemic AL amyloidosis
- Patients diagnosed with AL amyloidosis
- 2
Original publication
Early Diagnosis of ATTR-CM Using Carpal Tunnel Biopsy Examination. JACC Heart Fail. Published 13 January 2026. doi:10.1016/j.jchf.2025.102890
Summarised from the published abstract; every number is checked against it