TY - JOUR T1 - Global and Regional Variations in Transthyretin Cardiac Amyloidosis: A Comparison of Longitudinal Strain and <sup>99m</sup>Tc-Pyrophosphate Imaging JF - Journal of Nuclear Medicine Technology JO - J. Nucl. Med. Technol. SP - 30 LP - 37 DO - 10.2967/jnmt.120.261893 VL - 50 IS - 1 AU - Christopher Lee AU - Chieh-Ju Chao AU - Pradyumna Agasthi AU - Amith R. Seri AU - Amar Shere AU - Lanyu Mi AU - Lisa Brown AU - Chance Marostica AU - Timothy Barry AU - Ming Yang AU - Julie Rosenthal AU - Samuel Unzek AU - Farouk Mookadam AU - Reza Arsanjani Y1 - 2022/03/01 UR - http://tech.snmjournals.org/content/50/1/30.abstract N2 - There are limited data on the head-to-head comparison of 99mTc-pyrophosphate (99mTc-PYP) and echocardiographic strain imaging in the assessment of transthyretin (TTR) cardiac amyloidosis. Methods: At Mayo Clinic Arizona, patients who had undergone both a 99mTc-PYP scan and a transthoracic echocardiogram within a 90-d period were retrospectively identified for chart review and strain imaging analysis. Patients were divided into 2 groups according to their 99mTc-PYP results (PYP-positive [PYP+] or PYP-negative [PYP−]) for the comparison. A standard 17-segment model was used for segmental, regional, and global longitudinal strain comparison. A P value of less than 0.05 was deemed significant. Results: In total, 64 patients were included, the mean age was 75.1 ± 13.0 y, and 57 (89.1%) were male. Comparing the PYP+ to the PYP− group, the left ventricular global longitudinal strain was significantly worse in the former (PYP+ vs. PYP−, −10.5 ± 2.6 vs. −13.1 ± 4.1; P = 0.003). PYP+ patients also had worse regional basal strain (−4.6 ± 2.6 vs. −8.8 ± 4.0, P &lt; 0.001) and a trend toward worse midventricular strain (−9.6 ± 4.0 vs. −11.7 ± 4.4, P = 0.07), but there was no statistical difference in the apical region (−17.6 ± 4.73 vs. −19.0 ± 6.46, P = 0.35). This is consistent with an apex-sparing pattern shown by the relative apical longitudinal strain index (1.3 ± 0.5 vs. 1.0 ± 0.3, P = 0.008). Segment-to-segment analysis demonstrated a significant difference in strain between PYP+ and PYP− segments in 4 segments: basal inferior (P = 0.006), basal anterolateral (P = 0.01), apical septal (P = 0.002), and apical inferior (P = 0.001). Left ventricular diastolic dysfunction was significantly different, with 17 (77.3%) patients in the PYP+ group versus 15 (36.6%) in PYP− participants (P = 0.002). Conclusion: Our study suggested that 99mTc-PYP uptake is related to overall worse LV segmental, regional, and global longitudinal strain function, as well as diastolic function, compared with patients without 99mTc-PYP uptake. These data are important for helping clinicians learn about the echocardiographic function features related to 99mTc-PYP uptake and can help generate hypotheses for future studies. ER -