{"title":"野生型转甲状腺素淀粉样变性心肌病患者的发病年龄与通过99m锝-PYP闪烁成像量化的心肌淀粉样沉积之间存在反相关性。","authors":"Hiroshi Kanaya, Shinya Shiraishi, Kouji Ogasawara, Koya Iwashita, Fumi Sakamoto, Seiji Takashio, Yoshiki Mikami, Kenichi Tsujita, Toshinori Hirai","doi":"10.1007/s12149-024-01943-3","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) is increasingly recognized as a contributing factor to cardiac insufficiency in the elderly population. We aimed to identify the factors affecting age of onset of ATTRwt-CM, encompassing the assessment of amyloid deposition in myocardial tissue through the use of <sup>99m</sup>Tc-pyrophosphate (PYP) and clinical parameters.</p><h3>Methods</h3><p>A retrospective investigation involving a consecutive cohort of 107 cases, each having been diagnosed with ATTRwt-CM confirmed through histopathological and genetic analysis, was performed. All patients underwent PYP scintigraphy, and the heart-to-contralateral (H/CL) ratio was calculated to measure amyloid deposition in the myocardium. Univariate and multivariate analyses were performed to identify independent predictors of the age of onset of ATTRwt-CM, considering the H/CL ratio and various clinical risk factors for heart failure.</p><h3>Results</h3><p>Gender (<i>p = </i>0.03), Creatinine (Cr) (<i>r = </i>0.32, p < 0.01), hemoglobin (Hb) (<i>r = </i> − 0.44, <i>p < </i>0.01), albumin (Alb) (<i>r = </i> − 0.32, <i>p < </i>0.01), brain natriuretic peptide (BNP) (<i>r = </i>0.21, <i>p = </i>0.03), low-density lipoprotein-cholesterol (LDL-C) (<i>r = </i> − 0.27, <i>p < </i>0.01), and H/CL ratio (<i>r = </i> − 0.44, <i>p < </i>0.01) were all significantly associated with the onset age. In multiple regression analysis, the independent predictive factors for the onset age of ATTRwt-CM were identified as the H/CL ratio (<i>p < </i>0.01), Hb (<i>p < </i>0.01), and Cr (<i>p < </i>0.01).</p><h3>Conclusion</h3><p>The H/CL ratio, Hb, and Cr independently affect age of onset in patients with ATTRwt-CM. The H/CL ratio is inversely correlated with age of onset, and may be the sole factor in the development of heart failure in early onset patients, while it may have a synergistic effect on heart failure with anemia and renal dysfunction in late-onset patients.</p></div>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Inverse correlation between age of onset and myocardial amyloid deposition quantified by 99mTc-PYP scintigraphy in patients with wild-type transthyretin amyloid cardiomyopathy\",\"authors\":\"Hiroshi Kanaya, Shinya Shiraishi, Kouji Ogasawara, Koya Iwashita, Fumi Sakamoto, Seiji Takashio, Yoshiki Mikami, Kenichi Tsujita, Toshinori Hirai\",\"doi\":\"10.1007/s12149-024-01943-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) is increasingly recognized as a contributing factor to cardiac insufficiency in the elderly population. We aimed to identify the factors affecting age of onset of ATTRwt-CM, encompassing the assessment of amyloid deposition in myocardial tissue through the use of <sup>99m</sup>Tc-pyrophosphate (PYP) and clinical parameters.</p><h3>Methods</h3><p>A retrospective investigation involving a consecutive cohort of 107 cases, each having been diagnosed with ATTRwt-CM confirmed through histopathological and genetic analysis, was performed. All patients underwent PYP scintigraphy, and the heart-to-contralateral (H/CL) ratio was calculated to measure amyloid deposition in the myocardium. Univariate and multivariate analyses were performed to identify independent predictors of the age of onset of ATTRwt-CM, considering the H/CL ratio and various clinical risk factors for heart failure.</p><h3>Results</h3><p>Gender (<i>p = </i>0.03), Creatinine (Cr) (<i>r = </i>0.32, p < 0.01), hemoglobin (Hb) (<i>r = </i> − 0.44, <i>p < </i>0.01), albumin (Alb) (<i>r = </i> − 0.32, <i>p < </i>0.01), brain natriuretic peptide (BNP) (<i>r = </i>0.21, <i>p = </i>0.03), low-density lipoprotein-cholesterol (LDL-C) (<i>r = </i> − 0.27, <i>p < </i>0.01), and H/CL ratio (<i>r = </i> − 0.44, <i>p < </i>0.01) were all significantly associated with the onset age. In multiple regression analysis, the independent predictive factors for the onset age of ATTRwt-CM were identified as the H/CL ratio (<i>p < </i>0.01), Hb (<i>p < </i>0.01), and Cr (<i>p < </i>0.01).</p><h3>Conclusion</h3><p>The H/CL ratio, Hb, and Cr independently affect age of onset in patients with ATTRwt-CM. The H/CL ratio is inversely correlated with age of onset, and may be the sole factor in the development of heart failure in early onset patients, while it may have a synergistic effect on heart failure with anemia and renal dysfunction in late-onset patients.</p></div>\",\"PeriodicalId\":8007,\"journal\":{\"name\":\"Annals of Nuclear Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-06-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s12149-024-01943-3\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s12149-024-01943-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Inverse correlation between age of onset and myocardial amyloid deposition quantified by 99mTc-PYP scintigraphy in patients with wild-type transthyretin amyloid cardiomyopathy
Objective
Wild-type transthyretin amyloidosis cardiomyopathy (ATTRwt-CM) is increasingly recognized as a contributing factor to cardiac insufficiency in the elderly population. We aimed to identify the factors affecting age of onset of ATTRwt-CM, encompassing the assessment of amyloid deposition in myocardial tissue through the use of 99mTc-pyrophosphate (PYP) and clinical parameters.
Methods
A retrospective investigation involving a consecutive cohort of 107 cases, each having been diagnosed with ATTRwt-CM confirmed through histopathological and genetic analysis, was performed. All patients underwent PYP scintigraphy, and the heart-to-contralateral (H/CL) ratio was calculated to measure amyloid deposition in the myocardium. Univariate and multivariate analyses were performed to identify independent predictors of the age of onset of ATTRwt-CM, considering the H/CL ratio and various clinical risk factors for heart failure.
Results
Gender (p = 0.03), Creatinine (Cr) (r = 0.32, p < 0.01), hemoglobin (Hb) (r = − 0.44, p < 0.01), albumin (Alb) (r = − 0.32, p < 0.01), brain natriuretic peptide (BNP) (r = 0.21, p = 0.03), low-density lipoprotein-cholesterol (LDL-C) (r = − 0.27, p < 0.01), and H/CL ratio (r = − 0.44, p < 0.01) were all significantly associated with the onset age. In multiple regression analysis, the independent predictive factors for the onset age of ATTRwt-CM were identified as the H/CL ratio (p < 0.01), Hb (p < 0.01), and Cr (p < 0.01).
Conclusion
The H/CL ratio, Hb, and Cr independently affect age of onset in patients with ATTRwt-CM. The H/CL ratio is inversely correlated with age of onset, and may be the sole factor in the development of heart failure in early onset patients, while it may have a synergistic effect on heart failure with anemia and renal dysfunction in late-onset patients.
期刊介绍:
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.