Academic Journal
Monitoring tafamidis treatment with quantitative SPECT/CT in transthyretin amyloid cardiomyopathy
| Title: | Monitoring tafamidis treatment with quantitative SPECT/CT in transthyretin amyloid cardiomyopathy |
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| Authors: | Rettl, René, Wollenweber, Tim, Duca, Franz, Binder, Christina, Cherouny, Bernhard, Dachs, Theresa-Marie, Camuz Ligios, Luciana, Schrutka, Lore, Dalos, Daniel, Beitzke, Dietrich, Loewe, Christian, Badr Eslam, Roza, Kastner, Johannes, Hacker, Marcus, Bonderman, Diana |
| Superior Title: | Eur Heart J Cardiovasc Imaging |
| Publisher Information: | Oxford University Press |
| Publication Year: | 2023 |
| Collection: | PubMed Central (PMC) |
| Subject Terms: | Original Paper |
| Description: | AIMS: Tafamidis treatment positively affects left ventricular (LV) structure and function and improves outcomes in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). We aimed to investigate the relationship between treatment response and cardiac amyloid burden identified by serial quantitative (99m)Tc-DPD SPECT/CT. We furthermore aimed to identify nuclear imaging biomarkers that could be used to quantify and monitor response to tafamidis therapy. METHODS AND RESULTS: Forty wild-type ATTR-CM patients who underwent (99m)Tc-DPD scintigraphy and SPECT/CT imaging at baseline and after treatment with tafamidis 61 mg once daily [median, 9.0 months (interquartile range 7.0–10.0)] were divided into two cohorts based on the median (−32.3%) of the longitudinal percent change in standardized uptake value (SUV) retention index. ATTR-CM patients with a reduction greater than or equal to the median (n = 20) had a significant decrease in SUV retention index (P < 0.001) at follow-up, which translated into significant benefits in serum N-terminal prohormone of brain natriuretic peptide levels (P = 0.006), left atrial volume index (P = 0.038), as well as LV [LV global longitudinal strain: P = 0.028, LV ejection fraction (EF): P = 0.027, LV cardiac index (CI): P = 0.034] and right ventricular (RV) [RVEF: P = 0.025, RVCI: P = 0.048] functions compared with patients with a decrease less than the median (n = 20). CONCLUSION: Treatment with tafamidis in ATTR-CM patients results in a significant reduction in SUV retention index, associated with significant benefits for LV and RV function and cardiac biomarkers. Serial quantitative (99m)Tc-DPD SPECT/CT imaging with SUV may be a valid tool to quantify and monitor response to tafamidis treatment in affected patients. TRANSLATIONAL PERSPECTIVE: (99m)Tc-DPD SPECT/CT imaging with determination of SUV retention index as part of a routine annual examination can provide evidence of treatment response in ATTR-CM patients receiving disease-modifying therapy. Further long-term studies ... |
| Document Type: | text |
| Language: | English |
| Relation: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364619/; http://www.ncbi.nlm.nih.gov/pubmed/36881774; http://dx.doi.org/10.1093/ehjci/jead030 |
| DOI: | 10.1093/ehjci/jead030 |
| Availability: | https://doi.org/10.1093/ehjci/jead030 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364619/ http://www.ncbi.nlm.nih.gov/pubmed/36881774 |
| Rights: | © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. ; https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Accession Number: | edsbas.64E1254F |
| Database: | BASE |
| Description not available. |