Heart failure & cardiomyopathies
Nuclear Imaging and Echocardiographic Findings in Hypertrophic Cardiomyopathy with and without ATTR-CM
Authors' conclusion
In this real-world study, a high level of concordance was seen in cardiac uptake grading on planar versus SPECT imaging, with discordant findings only observed with [99mTc]Tc-PYP.
Study context
- Population
- Patients aged ≥50 years with hypertrophic cardiomyopathy (HCM) (left ventricular (LV) wall thickness ≥15 mm without identified cause) screened for ATTR-CM75 (9.8%) planar plus SPECT
- Participants
- 766 patients
- Exposure
- ATTR-CM vs no cardiac uptake; planar vs SPECT imaging
- Outcome
- Frequency of use of planar scintigraphy with and without SPECT; concordance of cardiac uptake grading (Perugini 0-3)
Methodological detailsreal-world, screening study (TTRACK)
- Real-world
- Screening study (TTRACK)
Main finding
As reported in the abstract
- Planar imaging alone
- 691 (90.2%)
- Planar plus SPECT imaging
- 75 (9.8%)
- Cardiac uptake
- 245 patients (32.0%)
- Grade 1
- 37 (4.8%)
- Grade 2
- 34 (4.4%)
- Grade 3
- 174 (22.7%)
- Onsite planar grading vs consensus, κ
- 0.84 (95% CI 0.81-0.88)
- Planar vs SPECT grading, κ
- 0.93 (95% CI 0.86-1.00)
Observational data: associations, not effects.
Further findings
Echocardiographic findings · LVEF
P < 0.001
Mean LVEF
Mean LV mass index ATTR-CM 179.0 g/m² · No cardiac uptake 155.6 g/m²
Preserved apical strain
P < 0.05
Concentric hypertrophic pattern
| Outcome | P value |
|---|---|
| Echocardiographic findingsLV mass index | P < 0.01 |
| Echocardiographic findingsHypertrophic pattern | P < 0.001 |
Echocardiographic findings
- High clinical overlap between ATTR-CM and no cardiac uptake
Original publication
Nuclear Imaging and Echocardiographic Findings in Hypertrophic Cardiomyopathy with and without ATTR-CM. ESC Heart Fail. Published 13 October 2025. doi:10.
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