Abstract

Objective: To characterize and compare the clinical, laboratory, and imaging profiles of light-chain (AL) and transthyretin (ATTR) cardiac amyloidosis in a single-center setting.
Methodology: We retrospectively analyzed 54 patients who underwent 99mTc-DPD SPECT-CT at our center between 2021-2024. Data collected included demographics, medical history, cardiac biomarkers, echocardiography results, and tissue biopsies. Myocardial uptake intensity was graded using the Perugini system (0-3).
Results: Nine patients were diagnosed with ATTR cardiac amyloidosis (ATTR-CM) and four with AL amyloidosis. ATTR-CM patients (62-84 years) and AL-CM patients (55-75 years) both presented with dyspnea and peripheral edema, but autonomic symptoms and extracardiac manifestations (carpal tunnel syndrome, lumbar stenosis) were more prevalent in ATTR-CM. All ATTR-CM patients demonstrated left ventricular hypertrophy, with eight showing concentric hypertrophy. AL amyloidosis patients exhibited no myocardial uptake on bone scintigraphy (grade 0).
Conclusion: The male predominance and concentric hypertrophy in ATTR-CM align with existing literature, while negative scintigraphy in AL cases reinforces its diagnostic utility.

Key words: Cardiac amyloidosis, transthyretin amyloidosis (ATTR), light-chain amyloidosis (AL), bone scintigraphy, echocardiography.