当前位置：
X-MOL 学术
›
J. Am. Coll. Cardiol.
›
论文详情
Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Cardiac Scintigraphy With Technetium-99m-Labeled Bone-Seeking Tracers for Suspected Amyloidosis
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2020-06-01 , DOI: 10.1016/j.jacc.2020.04.022 Mazen Hanna 1 , Frederick L Ruberg 2 , Mathew S Maurer 3 , Angela Dispenzieri 4 , Sharmila Dorbala 5 , Rodney H Falk 5 , James Hoffman 6 , Wael Jaber 1 , Prem Soman 7 , Ronald M Witteles 8 , Martha Grogan 9
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2020-06-01 , DOI: 10.1016/j.jacc.2020.04.022 Mazen Hanna 1 , Frederick L Ruberg 2 , Mathew S Maurer 3 , Angela Dispenzieri 4 , Sharmila Dorbala 5 , Rodney H Falk 5 , James Hoffman 6 , Wael Jaber 1 , Prem Soman 7 , Ronald M Witteles 8 , Martha Grogan 9
Affiliation
|
Technetium-labeled cardiac scintigraphy (i.e., Tc-PYP scan) has been repurposed for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM). Validated in cohorts of patients with heart failure and echocardiographic and/or cardiac magnetic resonance imaging findings suggestive of cardiac amyloidosis, cardiac scintigraphy can confirm the diagnosis of ATTR-CM only when combined with blood and urine testing to exclude a monoclonal protein. Multisocietal guidelines support the nonbiopsy diagnosis of ATTR-CM using cardiac scintigraphy, yet emphasize its use in the appropriate clinical context and the crucial need to rule out light chain amyloid cardiomyopathy. Although increased awareness of ATTR-CM and the advent of effective therapy have led to rapid adoption of diagnostic scintigraphy, there is heterogeneity in adherence to consensus guidelines. This perspective outlines clinical scenarios wherein findings on technetium-labeled cardiac scintigraphy have been misinterpreted, reviews causes of false-negative and false-positive results, and provides strategies to avoid costly and potentially fatal misdiagnoses.
中文翻译：
用锝 99m 标记的寻骨示踪剂对疑似淀粉样变性进行心脏闪烁扫描
锝标记的心脏闪烁扫描（即 Tc-PYP 扫描）已被重新用于诊断转甲状腺素蛋白淀粉样变心肌病 (ATTR-CM)。在心力衰竭患者队列中验证，超声心动图和/或心脏磁共振成像结果提示心脏淀粉样变性，只有在结合血液和尿液检测以排除单克隆蛋白时，心脏闪烁扫描才能确认 ATTR-CM 的诊断。多社会指南支持使用心脏闪烁扫描法对 ATTR-CM 进行非活检诊断，但强调其在适当的临床环境中的使用以及排除轻链淀粉样变心肌病的关键需求。尽管人们对 ATTR-CM 认识的提高和有效疗法的出现导致了诊断性闪烁扫描的快速采用，在遵守共识指南方面存在异质性。该观点概述了临床情况，其中锝标记的心脏闪烁扫描的结果被误解，回顾了假阴性和假阳性结果的原因，并提供了避免代价高昂且可能致命的误诊的策略。
更新日期：2020-06-01
中文翻译：
用锝 99m 标记的寻骨示踪剂对疑似淀粉样变性进行心脏闪烁扫描
锝标记的心脏闪烁扫描（即 Tc-PYP 扫描）已被重新用于诊断转甲状腺素蛋白淀粉样变心肌病 (ATTR-CM)。在心力衰竭患者队列中验证，超声心动图和/或心脏磁共振成像结果提示心脏淀粉样变性，只有在结合血液和尿液检测以排除单克隆蛋白时，心脏闪烁扫描才能确认 ATTR-CM 的诊断。多社会指南支持使用心脏闪烁扫描法对 ATTR-CM 进行非活检诊断，但强调其在适当的临床环境中的使用以及排除轻链淀粉样变心肌病的关键需求。尽管人们对 ATTR-CM 认识的提高和有效疗法的出现导致了诊断性闪烁扫描的快速采用，在遵守共识指南方面存在异质性。该观点概述了临床情况，其中锝标记的心脏闪烁扫描的结果被误解，回顾了假阴性和假阳性结果的原因，并提供了避免代价高昂且可能致命的误诊的策略。
京公网安备 11010802027423号