Assessment of incidental cardiac uptake in bone scintigraphy across Spain: The ECCINGO study

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Abstract

Aim

Myocardial uptake on bone scintigraphy has become useful for the detection of transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to assess the prevalence of myocardial uptake in patients over 18 years of age with no clinical suspicion of cardiac amyloidosis (CA) who had undergone bone scintigraphy.

Methods and results

This was an observational, retrospective, multicenter study across 21 Spanish hospitals (September–November 2019). Of the 9864 scans analyzed (locally and centrally), incidental cardiac uptake was observed in 71 patients (0.72%), a prevalence that increased with age. A previous diagnosis of heart failure was found in 16.9% of patients with positive uptake, with >50% in NYHA II. ATTR-CA was diagnosed in 10 patients, with a mean delay of 10.4 months (95% CI: 5.1–15.7). All were >70 years old, primarily male, and had greater left ventricular hypertrophy than patients without a confirmed diagnosis (p < 0.0001). ATTR-CA patients had higher rates of orthostatic hypotension (30.0% vs. 3.8% in non-ATTR-CA; p = 0.025).

Conclusions

This is the first retrospective, national, multicenter study evaluating the prevalence of incidental cardiac uptake in bone scintigraphy performed for non-cardiac reasons, showing a prevalence of 0.72% in this population. Referral of these patients may facilitate early diagnosis of CA with a resulting benefit for patients.

西班牙骨闪烁成像中偶然摄取的心脏摄取量评估--ECCINGO 研究。
目的:骨闪烁成像的心肌摄取已成为检测转甲状腺素心脏淀粉样变性(ATTR-CA)的有用方法。本研究旨在评估 18 岁以上、临床上未怀疑患有心脏淀粉样变性(CA)但接受了骨闪烁扫描的患者的心肌摄取率:这是一项跨越 21 家西班牙医院的观察性、回顾性、多中心研究(2019 年 9 月至 11 月)。在分析的 9864 次扫描(局部和中央)中,有 71 例患者(0.72%)观察到偶然的心脏摄取,其发生率随年龄增长而增加。16.9%的摄取阳性患者既往诊断为心力衰竭,其中超过50%为NYHA II。10名患者确诊为ATTR-CA,平均延迟时间为10.4个月(95% CI:5.1-15.7)。所有患者的年龄均大于 70 岁,主要为男性,与未确诊的患者相比,左心室肥厚程度更高(P 结论:ATTR-CA 患者的左心室肥厚程度高于未确诊的患者:这是第一项全国性多中心回顾性研究,评估了因非心脏原因进行骨闪烁扫描时偶然摄取心脏信号的发生率,结果显示该人群的发生率为 0.72%。转诊这些患者可促进 CA 的早期诊断,从而使患者受益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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