pattern of myocardial 99m tc-hmdp uptake and impact on myocardial function in patients with transthyretin cardiac amyloidosis

The purpose of the study was to describe the pattern of 99mtc-labeled phosphate agents myocardial uptake by scintigraphy and explore its impact on left ventricular (lv) functions in transthyretin cardiac amyloidosis (ttr-ca). fifty patients with ttr-ca underwent 99mtc- hydroxymethylene-diphosphonate (99mtc-hmdp) scintigraphy and echocardiography with measure of lv thickness, longitudinal strain (ls), systolic and diastolic functions. cardiac retention by scintigraphy was assessed by visual scoring and the heart/whole body (h/wb) ratio was calculated by dividing counts in the heart by counts in late whole-body images. the mean population age was 79 ± 10 years. mean h/wb ratio was 12 ± 7. myocardial 99mtc-hmdp uptake on segments 5, 6, 7, 8, 11, 12, 13, 14, 16, and 17 was correlated with h/wb ratio. mean lvef and global ls were 51 ± 10% and − 10 ± 3%, respectively. h/wb ratio was correlated with global ls (r = 0.408, p = .003), ea (r = − 0.566, p < .001) and mean left ventricular wall thickness (r = 0.476, p < .001) but not with lvef (r = − 0.109, p = .453). segmental myocardial uptake was slightly correlated with segmental ls (r = 0.152, p < .001). h/wb ratio was not correlated with nt-probnp levels (r = 0.219, p = .148) neither e/ea ratio (r = 0.204, p = .184). these findings show the relationship between bone tracer myocardial uptake and lv functions in patients with ttr cardiac amyloidosis.