Abstract：
OBJECTIVE: 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.
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.
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.
摘要：
目的：骨闪烁显像的心肌摄取已成为检测甲状腺素运载蛋白心脏淀粉样变性（ATTR-CA）的有用方法。这项研究旨在评估18岁以上没有临床怀疑患有心脏淀粉样变性（CA）的患者接受骨闪烁显像的心肌摄取患病率。
结果：这是一个观察性的，回顾性,西班牙21家医院的多中心研究（2019年9月至11月）。在分析的9864次扫描中(本地和集中)，在71例患者中观察到偶然的心脏摄取（0.72％），患病率随年龄增长而增加。先前诊断为心力衰竭的患者中有16.9％的摄取阳性，NYHAII>50%。在10例患者中诊断出ATTR-CA，平均延迟10.4个月（95%CI：5.1-15.7）。都是70岁以上,主要是男性,与未确诊的患者相比，左心室肥厚更大（p<0.0001）。ATTR-CA患者的体位性低血压发生率较高(30.0%vs.非ATTR-CA中为3.8%；p=0.025）。
结论：这是第一次回顾，国家,多中心研究评估因非心脏原因进行的骨闪烁显像中偶然心脏摄取的患病率，在该人群中患病率为0.72%。这些患者的转诊可能有助于CA的早期诊断，从而为患者带来益处。
结果：这是一个观察性的，回顾性,西班牙21家医院的多中心研究（2019年9月至11月）。在分析的9864次扫描中(本地和集中)，在71例患者中观察到偶然的心脏摄取（0.72％），患病率随年龄增长而增加。先前诊断为心力衰竭的患者中有16.9％的摄取阳性，NYHAII>50%。在10例患者中诊断出ATTR-CA，平均延迟10.4个月（95%CI：5.1-15.7）。都是70岁以上,主要是男性,与未确诊的患者相比，左心室肥厚更大（p<0.0001）。ATTR-CA患者的体位性低血压发生率较高(30.0%vs.非ATTR-CA中为3.8%；p=0.025）。
结论：这是第一次回顾，国家,多中心研究评估因非心脏原因进行的骨闪烁显像中偶然心脏摄取的患病率，在该人群中患病率为0.72%。这些患者的转诊可能有助于CA的早期诊断，从而为患者带来益处。
