Literature DB >> 35666046

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Year:  2022        PMID: 35666046      PMCID: PMC9288789          DOI: 10.1002/ehf2.14007

Source DB:  PubMed          Journal:  ESC Heart Fail        ISSN: 2055-5822


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In the original published version of the paper of Tahara et al. the authors noticed errors in ‘False positives, false negatives, and inconsistencies between 99mTc‐PYP scintigraphy and biopsy findings’ section and Tables and .
Table 2

Typical false‐positive and false‐negative cases in planar 99mTc‐PYP scintigraphy for the diagnosis of ATTR‐CM

Planar 99mTc‐PYP scintigraphy resultsPotential causes of false results
False positive

Recent myocardial infarction (<4 weeks)

Rib fractures and valvular/annular calcifications

AL amyloidosis

AApoAI, AApoAII, AApoAIV, and Aβ2M

Hypertrophic cardiomyopathy

Hydroxychloroquine toxicity

Cardiac blood pool

Intravenous iron injections

False negative

Insufficient amount of amyloid deposits

Delayed or premature acquisition in 99m Tc‐PYP scintigraphy

ATTRv‐CM with a low sensitivity in scintigraphy (Ser77Tyr or Phe64Leu mutation)

Initial diagnosis of cardiac pools with myocardial deposits

Table 3

Potential causes of inconsistencies between planar 99mTc‐PYP scintigraphy and biopsy findings in suspected ATTR‐CM

Planar 99mTc‐PYP scintigraphyBiopsyPotential causes of inconsistencies
PositiveNegative

Sampling errors in biopsy

Errors in scintigraphy imaging time or evaluation

Errors in pathological diagnosis

Cardiac pools

Deposit of proteins other than transthyretin (e.g. AL)

NegativePositive

Errors in scintigraphy evaluation

Errors in pathological diagnosis

Deposit of proteins other than transthyretin (e.g. AL)

ATTRv‐CM with a low sensitivity in 99mTc‐PYP scintigraphy (Ser77Tyr or Phe64Leu mutation)

On page 257 of the article, in the ‘False positives, false negatives, and inconsistencies between 99mTc‐PYP scintigraphy and biopsy findings’ section, the cases of ‘rib fractures, valvular/annular calcifications, and recent myocardial infarction’ need to be regarded as false positive instead of false negative. The revised main text should thus read as follows: ‘False‐positive cases in 99mTc‐PYP scintigraphy for ATTR‐CM may include Grade 2 or 3 myocardial uptake; recent myocardial infarction (<4 weeks) ; rib fractures ; valvular/annular calcifications ; AL amyloidosis34,54,69–73; apolipoprotein AI amyloidosis (AApoAI), apolipoprotein AII amyloidosis (AApoAII), apolipoprotein A‐IV amyloidosis (ApoAAIV), or β2‐microglobulin amyloidosis (Aβ2M)10; hypertrophic cardiomyopathy74,75; hydroxychloroquine toxicity76; and cardiac blood pools.54 Case reports on false‐positive myocardial uptake following intravenous iron injections have been published for 99mTc‐DPD and 99mTc‐HMDP scintigraphy.77,78 In contrast, Grade 0 or 1 myocardial uptake, an insufficient amount of amyloid deposits, delayed or premature acquisition in Tc‐PYP scintigraphy, ATTRv‐CM with a low sensitivity for 99mTc‐labelled bone radiotracer scintigraphy (Ser77Tyr or Phe64Leu mutation),10,80 and initial diagnosis of cardiac pools with myocardial deposits81 are examples of possible false‐negative cases (Table ).’ Similarly, the current Table (page 258). ‘Rib fractures and valvular/annular calcifications’ and ‘Recent myocardial infarction (<4 weeks)’ should be removed from false negative causes and combined into false‐positive causes. The revised Table should read as follows: Typical false‐positive and false‐negative cases in planar 99mTc‐PYP scintigraphy for the diagnosis of ATTR‐CM Recent myocardial infarction (<4 weeks) Rib fractures and valvular/annular calcifications AL amyloidosis AApoAI, AApoAII, AApoAIV, and Aβ2M Hypertrophic cardiomyopathy Hydroxychloroquine toxicity Cardiac blood pool Intravenous iron injections Insufficient amount of amyloid deposits Delayed or premature acquisition in Tc‐PYP scintigraphy ATTRv‐CM with a low sensitivity in scintigraphy (Ser77Tyr or Phe64Leu mutation) Initial diagnosis of cardiac pools with myocardial deposits In addition, the current Table (page 258). The Ser77Tyr mutation should be added to ‘ATTRv‐CM with a low sensitivity in 99mTc‐PYP scintigraphy (Phe64Leu mutation)’ for consistency with Table . The revised Table should thus read as follows: Potential causes of inconsistencies between planar 99mTc‐PYP scintigraphy and biopsy findings in suspected ATTR‐CM Sampling errors in biopsy Errors in scintigraphy imaging time or evaluation Errors in pathological diagnosis Cardiac pools Deposit of proteins other than transthyretin (e.g. AL) Errors in scintigraphy evaluation Errors in pathological diagnosis Deposit of proteins other than transthyretin (e.g. AL) ATTRv‐CM with a low sensitivity in 99mTc‐PYP scintigraphy (Ser77Tyr or Phe64Leu mutation) These errors occurred due to an inadvertent oversight and misinterpretation of source data. This change will not impact any other part of the manuscript including the abstract, and it does not change the data interpretation or conclusions in any way.
  1 in total

Review 1.  99m Technetium-pyrophosphate scintigraphy: a practical guide for early diagnosis of transthyretin amyloid cardiomyopathy.

Authors:  Nobuhiro Tahara; Olivier Lairez; Jin Endo; Atsushi Okada; Mitsuharu Ueda; Tomonori Ishii; Yoshinobu Kitano; Hahn-Ey Lee; Eleonora Russo; Toru Kubo
Journal:  ESC Heart Fail       Date:  2021-11-29
  1 in total

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