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Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis
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| Zeitschriftentitel: | European Heart Journal |
|---|---|
| Personen und Körperschaften: | , , , , , , , , , , , , , , , |
| In: | European Heart Journal, 38, 2017, 24, S. 1905-1908 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Oxford University Press (OUP)
|
| Schlagwörter: |
| author_facet |
Quarta, Candida Cristina Gonzalez-Lopez, Esther Gilbertson, Janet A. Botcher, Nichola Rowczenio, Dorota Petrie, Aviva Rezk, Tamer Youngstein, Taryn Mahmood, Shameem Sachchithanantham, Sajitha Lachmann, Helen J. Fontana, Marianna Whelan, Carol J. Wechalekar, Ashutosh D. Hawkins, Philip N. Gillmore, Julian D. Quarta, Candida Cristina Gonzalez-Lopez, Esther Gilbertson, Janet A. Botcher, Nichola Rowczenio, Dorota Petrie, Aviva Rezk, Tamer Youngstein, Taryn Mahmood, Shameem Sachchithanantham, Sajitha Lachmann, Helen J. Fontana, Marianna Whelan, Carol J. Wechalekar, Ashutosh D. Hawkins, Philip N. Gillmore, Julian D. |
|---|---|
| author |
Quarta, Candida Cristina Gonzalez-Lopez, Esther Gilbertson, Janet A. Botcher, Nichola Rowczenio, Dorota Petrie, Aviva Rezk, Tamer Youngstein, Taryn Mahmood, Shameem Sachchithanantham, Sajitha Lachmann, Helen J. Fontana, Marianna Whelan, Carol J. Wechalekar, Ashutosh D. Hawkins, Philip N. Gillmore, Julian D. |
| spellingShingle |
Quarta, Candida Cristina Gonzalez-Lopez, Esther Gilbertson, Janet A. Botcher, Nichola Rowczenio, Dorota Petrie, Aviva Rezk, Tamer Youngstein, Taryn Mahmood, Shameem Sachchithanantham, Sajitha Lachmann, Helen J. Fontana, Marianna Whelan, Carol J. Wechalekar, Ashutosh D. Hawkins, Philip N. Gillmore, Julian D. European Heart Journal Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis Cardiology and Cardiovascular Medicine |
| author_sort |
quarta, candida cristina |
| spelling |
Quarta, Candida Cristina Gonzalez-Lopez, Esther Gilbertson, Janet A. Botcher, Nichola Rowczenio, Dorota Petrie, Aviva Rezk, Tamer Youngstein, Taryn Mahmood, Shameem Sachchithanantham, Sajitha Lachmann, Helen J. Fontana, Marianna Whelan, Carol J. Wechalekar, Ashutosh D. Hawkins, Philip N. Gillmore, Julian D. 0195-668X 1522-9645 Oxford University Press (OUP) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1093/eurheartj/ehx047 <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Congo red staining of an endomyocardial biopsy is the diagnostic gold-standard in suspected cardiac amyloidosis (CA), but the procedure is associated with the risk, albeit small, of serious complications, and delay in diagnosis due to the requirement for technical expertise. In contrast, abdominal fat pad fine needle aspiration (FPFNA) is a simple, safe and well-established procedure in systemic amyloidosis, but its diagnostic sensitivity in patients with suspected CA remains unclear.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>We assessed the diagnostic sensitivity of FPFNA in 600 consecutive patients diagnosed with CA [216 AL amyloidosis, 113 hereditary transthyretin (ATTRm), and 271 wild-type transthyretin (ATTRwt) amyloidosis] at our Centre. Amyloid was detected on Congo red staining of FPFNAs in 181/216 (84%) patients with cardiac AL amyloidosis, including 100, 97, and 78% of those with a large, moderate, and small whole-body amyloid burden, respectively, as assessed by serum amyloid P (SAP) component scintigraphy (P &lt; 0.001); the deposits were successfully typed as AL by immunohistochemistry in 102/216 (47%) cases. Amyloid was detected in FPFNAs of 51/113 (45%) patients with ATTRm CA, and only 42/271 (15%) cases with ATTRwt CA.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>FPFNA has reasonable diagnostic sensitivity in cardiac AL amyloidosis, particularly in patients with a large whole-body amyloid burden. Although the diagnostic sensitivity of FPFNA is substantially lower in transthyretin CA, particularly ATTRwt, it may nevertheless sometimes obviate the need for endomyocardial biopsy.</jats:p> </jats:sec> Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis European Heart Journal |
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| title |
Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_unstemmed |
Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_full |
Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_fullStr |
Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_full_unstemmed |
Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_short |
Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_sort |
diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| topic |
Cardiology and Cardiovascular Medicine |
| url |
http://dx.doi.org/10.1093/eurheartj/ehx047 |
| publishDate |
2017 |
| physical |
1905-1908 |
| description |
<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Aims</jats:title>
<jats:p>Congo red staining of an endomyocardial biopsy is the diagnostic gold-standard in suspected cardiac amyloidosis (CA), but the procedure is associated with the risk, albeit small, of serious complications, and delay in diagnosis due to the requirement for technical expertise. In contrast, abdominal fat pad fine needle aspiration (FPFNA) is a simple, safe and well-established procedure in systemic amyloidosis, but its diagnostic sensitivity in patients with suspected CA remains unclear.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods and results</jats:title>
<jats:p>We assessed the diagnostic sensitivity of FPFNA in 600 consecutive patients diagnosed with CA [216 AL amyloidosis, 113 hereditary transthyretin (ATTRm), and 271 wild-type transthyretin (ATTRwt) amyloidosis] at our Centre. Amyloid was detected on Congo red staining of FPFNAs in 181/216 (84%) patients with cardiac AL amyloidosis, including 100, 97, and 78% of those with a large, moderate, and small whole-body amyloid burden, respectively, as assessed by serum amyloid P (SAP) component scintigraphy (P &lt; 0.001); the deposits were successfully typed as AL by immunohistochemistry in 102/216 (47%) cases. Amyloid was detected in FPFNAs of 51/113 (45%) patients with ATTRm CA, and only 42/271 (15%) cases with ATTRwt CA.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>FPFNA has reasonable diagnostic sensitivity in cardiac AL amyloidosis, particularly in patients with a large whole-body amyloid burden. Although the diagnostic sensitivity of FPFNA is substantially lower in transthyretin CA, particularly ATTRwt, it may nevertheless sometimes obviate the need for endomyocardial biopsy.</jats:p>
</jats:sec> |
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| author | Quarta, Candida Cristina, Gonzalez-Lopez, Esther, Gilbertson, Janet A., Botcher, Nichola, Rowczenio, Dorota, Petrie, Aviva, Rezk, Tamer, Youngstein, Taryn, Mahmood, Shameem, Sachchithanantham, Sajitha, Lachmann, Helen J., Fontana, Marianna, Whelan, Carol J., Wechalekar, Ashutosh D., Hawkins, Philip N., Gillmore, Julian D. |
| author_facet | Quarta, Candida Cristina, Gonzalez-Lopez, Esther, Gilbertson, Janet A., Botcher, Nichola, Rowczenio, Dorota, Petrie, Aviva, Rezk, Tamer, Youngstein, Taryn, Mahmood, Shameem, Sachchithanantham, Sajitha, Lachmann, Helen J., Fontana, Marianna, Whelan, Carol J., Wechalekar, Ashutosh D., Hawkins, Philip N., Gillmore, Julian D., Quarta, Candida Cristina, Gonzalez-Lopez, Esther, Gilbertson, Janet A., Botcher, Nichola, Rowczenio, Dorota, Petrie, Aviva, Rezk, Tamer, Youngstein, Taryn, Mahmood, Shameem, Sachchithanantham, Sajitha, Lachmann, Helen J., Fontana, Marianna, Whelan, Carol J., Wechalekar, Ashutosh D., Hawkins, Philip N., Gillmore, Julian D. |
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| description | <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Congo red staining of an endomyocardial biopsy is the diagnostic gold-standard in suspected cardiac amyloidosis (CA), but the procedure is associated with the risk, albeit small, of serious complications, and delay in diagnosis due to the requirement for technical expertise. In contrast, abdominal fat pad fine needle aspiration (FPFNA) is a simple, safe and well-established procedure in systemic amyloidosis, but its diagnostic sensitivity in patients with suspected CA remains unclear.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>We assessed the diagnostic sensitivity of FPFNA in 600 consecutive patients diagnosed with CA [216 AL amyloidosis, 113 hereditary transthyretin (ATTRm), and 271 wild-type transthyretin (ATTRwt) amyloidosis] at our Centre. Amyloid was detected on Congo red staining of FPFNAs in 181/216 (84%) patients with cardiac AL amyloidosis, including 100, 97, and 78% of those with a large, moderate, and small whole-body amyloid burden, respectively, as assessed by serum amyloid P (SAP) component scintigraphy (P &lt; 0.001); the deposits were successfully typed as AL by immunohistochemistry in 102/216 (47%) cases. Amyloid was detected in FPFNAs of 51/113 (45%) patients with ATTRm CA, and only 42/271 (15%) cases with ATTRwt CA.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>FPFNA has reasonable diagnostic sensitivity in cardiac AL amyloidosis, particularly in patients with a large whole-body amyloid burden. Although the diagnostic sensitivity of FPFNA is substantially lower in transthyretin CA, particularly ATTRwt, it may nevertheless sometimes obviate the need for endomyocardial biopsy.</jats:p> </jats:sec> |
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| spelling | Quarta, Candida Cristina Gonzalez-Lopez, Esther Gilbertson, Janet A. Botcher, Nichola Rowczenio, Dorota Petrie, Aviva Rezk, Tamer Youngstein, Taryn Mahmood, Shameem Sachchithanantham, Sajitha Lachmann, Helen J. Fontana, Marianna Whelan, Carol J. Wechalekar, Ashutosh D. Hawkins, Philip N. Gillmore, Julian D. 0195-668X 1522-9645 Oxford University Press (OUP) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1093/eurheartj/ehx047 <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Congo red staining of an endomyocardial biopsy is the diagnostic gold-standard in suspected cardiac amyloidosis (CA), but the procedure is associated with the risk, albeit small, of serious complications, and delay in diagnosis due to the requirement for technical expertise. In contrast, abdominal fat pad fine needle aspiration (FPFNA) is a simple, safe and well-established procedure in systemic amyloidosis, but its diagnostic sensitivity in patients with suspected CA remains unclear.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>We assessed the diagnostic sensitivity of FPFNA in 600 consecutive patients diagnosed with CA [216 AL amyloidosis, 113 hereditary transthyretin (ATTRm), and 271 wild-type transthyretin (ATTRwt) amyloidosis] at our Centre. Amyloid was detected on Congo red staining of FPFNAs in 181/216 (84%) patients with cardiac AL amyloidosis, including 100, 97, and 78% of those with a large, moderate, and small whole-body amyloid burden, respectively, as assessed by serum amyloid P (SAP) component scintigraphy (P &lt; 0.001); the deposits were successfully typed as AL by immunohistochemistry in 102/216 (47%) cases. Amyloid was detected in FPFNAs of 51/113 (45%) patients with ATTRm CA, and only 42/271 (15%) cases with ATTRwt CA.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>FPFNA has reasonable diagnostic sensitivity in cardiac AL amyloidosis, particularly in patients with a large whole-body amyloid burden. Although the diagnostic sensitivity of FPFNA is substantially lower in transthyretin CA, particularly ATTRwt, it may nevertheless sometimes obviate the need for endomyocardial biopsy.</jats:p> </jats:sec> Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis European Heart Journal |
| spellingShingle | Quarta, Candida Cristina, Gonzalez-Lopez, Esther, Gilbertson, Janet A., Botcher, Nichola, Rowczenio, Dorota, Petrie, Aviva, Rezk, Tamer, Youngstein, Taryn, Mahmood, Shameem, Sachchithanantham, Sajitha, Lachmann, Helen J., Fontana, Marianna, Whelan, Carol J., Wechalekar, Ashutosh D., Hawkins, Philip N., Gillmore, Julian D., European Heart Journal, Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis, Cardiology and Cardiovascular Medicine |
| title | Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_full | Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_fullStr | Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_full_unstemmed | Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_short | Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_sort | diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| title_unstemmed | Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis |
| topic | Cardiology and Cardiovascular Medicine |
| url | http://dx.doi.org/10.1093/eurheartj/ehx047 |