Original ArticlesTransthyretin Cardiac Amyloidosis as Diagnosed by 99mTc-PYP Scanning in Patients with Acute Heart Failure and Preserved Ejection FractionLo Presti, Saberio MD*; Horvath, Sofia A. MD*; Mihos, Christos G. DO*; Rajadhyaksha, Chetan MD†; McCloskey, Veronica MD*; Santana, Orlando MD*Author Information From the *Echocardiography Laboratory, Columbia University Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL †Department of Radiology, Mount Sinai Medical Center, Miami Beach, FL. Received for publication January 31, 2019; accepted March 8, 2019. Reprints: Orlando Santana, MD, Echocardiography Laboratory, Columbia University Division of Cardiology, Mount Sinai Heart Institute, 4300 Alton Road, Miami Beach, FL 33140. E-mail: firstname.lastname@example.org. Critical Pathways in Cardiology: December 2019 - Volume 18 - Issue 4 - p 195-199 doi: 10.1097/HPC.0000000000000183 Buy Metrics Abstract Transthyretin amyloid deposition is present in 17% of autopsies of patients with heart failure and a preserved ejection fraction (HFpEF). 99mTechnetium-pyrophosphate scintigraphy (99mTc-PYP) is sensitive and specific to diagnose cardiac transthyretin amyloid deposition (ATTR). The prevalence of ATTR by 99mTc-PYP was evaluated along with echocardiographic parameters in patients with HFpEF. One-hundred consecutive patients with HFpEF, who had 99mTc-PYP, were retrospectively evaluated. Echocardiographic variables were analyzed to compare patients with positive versus negative ATTR infiltration. Myocardial ATTR was present in 19% of patients. Individuals with ATTR were older with a mean age of 82 ± 7 versus 75 ± 13 years (P = 0.03), had increased left ventricular hypertrophy with the interventricular septum measuring 1.6 (IQR, 1.4–2.0) versus 1.4 (IQR, 1.3–1.6) cm (P = 0.002), had a greater mean left ventricular mass index of 160 ± 50 g/m2 versus 131 ± 44 g/m2 (P = 0.01), and a reduced global longitudinal strain measuring −11% (IQR, −9 to −12) versus −12% (IQR, −10 to −16), P = 0.04. The prevalence of ATTR myocardial deposition demonstrated by 99mTc-PYP in patients with HFpEF is comparable to that of autopsy studies. It is more common in older patients, with increased left ventricular hypertrophy and reduced global longitudinal strain. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.