Non-invasive techniques for demonstrating cardiac involvement in the acquired forms of systemic amyloidosis

A prospective study was performed to evaluate the relative efficiency of technetium-99m-pyrophosphate (Tc-99m-PYP) myocardial scanning and M-mode and two dimensional (2D) echocardiography in detecting cardiac involvement in the acquired forms of systemic amyloidosis. Five patients with systemic amyloidosis (AL, 4 cases; AA, 1 case) had characteristic M-mode and 2D echocardiographic features indicative of cardiac involvement, and this was later confirmed histologically. In contrast, Tc-99m-PYP myocardial scanning was negative in all 5 patients. We conclude that echocardiography is a more sensitive and clinically useful investigation than Tc-99m-PYP scanning for detecting cardiac involvement in acquired systemic amyloidosis