florbetapir-f-18 and Heart-Diseases

Cardiac amyloidosis, a restrictive heart disease with high mortality and morbidity, is underdiagnosed due to limited targeted diagnostic imaging. The primary aim of this study was to evaluate the utility of (18)F-florbetapir for imaging cardiac amyloidosis.. We performed a pilot study of cardiac (18)F-florbetapir PET in 14 subjects: 5 control subjects without amyloidosis and 9 subjects with documented cardiac amyloidosis. Standardized uptake values (SUV) of (18)F-florbetapir in the left ventricular (LV) myocardium, blood pool, liver, and vertebral bone were determined. A (18)F-florbetapir retention index (RI) was computed. Mean LV myocardial SUVs, target-to-background ratio (TBR, myocardial/blood pool SUV ratio) and myocardial-to-liver SUV ratio between 0 and 30 min were calculated.. Left and right ventricular myocardial uptake of (18)F-florbetapir were noted in all the amyloid subjects and in none of the control subjects. The RI, TBR, LV myocardial SUV and LV myocardial to liver SUV ratio were all significantly higher in the amyloidosis subjects than in the control subjects (RI median 0.043 min(-1), IQR 0.034 - 0.051 min(-1), vs. 0.023 min(-1), IQR 0.015 - 0.025 min(-1), P = 0.002; TBR 1.84, 1.64 - 2.50, vs. 1.26, IQR 0.91 - 1.36, P = 0.001; LV myocardial SUV 3.84, IQR 1.87 - 5.65, vs. 1.35, IQR 1.17 - 2.28, P = 0.029; ratio of LV myocardial to liver SUV 0.67, IQR 0.44 - 1.64, vs. 0.18, IQR 0.15 - 0.35, P = 0.004). The myocardial RI, TBR and myocardial to liver SUV ratio also distinguished the control subjects from subjects with transthyretin and those with light chain amyloid.. (18)F-Florbetapir PET may be a promising technique to image light chain and transthyretin cardiac amyloidosis. Its role in diagnosing amyloid in other organ systems and in assessing response to therapy needs to be further studied.

Topics: Adult; Aged; Amyloid; Amyloidosis; Aniline Compounds; Biological Transport; Case-Control Studies; Diagnosis, Differential; Ethylene Glycols; Female; Heart Diseases; Humans; Male; Middle Aged; Myocardium; Organ Specificity; Pilot Projects; Positron-Emission Tomography; Prealbumin

Topics: Aged; Aged, 80 and over; Amyloid; Amyloid beta-Peptides; Aniline Compounds; Atherosclerosis; Atrial Fibrillation; Brain; Case-Control Studies; Cognitive Dysfunction; Cross-Sectional Studies; Echocardiography; Electrocardiography; Ethylene Glycols; Female; Heart Atria; Heart Diseases; Humans; Male; Natriuretic Peptide, Brain; Peptide Fragments; Positron-Emission Tomography; Risk Factors

Topics: Aged; Aniline Compounds; Ethylene Glycols; Female; Follow-Up Studies; Heart Diseases; Humans; Immunoglobulin Light-chain Amyloidosis; Male; Middle Aged; Pilot Projects; Positron-Emission Tomography; Prognosis; Prospective Studies

To explore early autonomic cardiac changes in pre-clinical Alzheimer's disease (AD), we have evaluated electrocardiologic measures of vagal tone for 63 adults (ages 55-75) at rest, during cognitive testing, and then again at rest. All subjects had multiple risk factors for AD, and all completed amyloid PET scans (18F-Florbetapir) to determine amyloid positivity (Aβ+). No change in electrocardiographic measures were observed for Aβ+ participants under each testing condition, whereas Aβ-subjects showed an expected increase in vagal tone during the cognitive stress condition. These findings suggest an early relationship between cortical Aβ accumulation, a precursor to AD development, and autonomic cardiac function.

Topics: Aged; Alzheimer Disease; Amyloid beta-Peptides; Aniline Compounds; Cognitive Dysfunction; Disease Progression; Electroencephalography; Ethylene Glycols; Female; Heart Diseases; Humans; Male; Mental Status Schedule; Middle Aged; Neuropsychological Tests; Positron-Emission Tomography; Risk Factors

Topics: Aged; Amyloidosis; Aniline Compounds; Echocardiography; Ethylene Glycols; Fluorine Radioisotopes; Heart Diseases; Humans; Magnetic Resonance Imaging; Male; Positron Emission Tomography Computed Tomography; Ventricular Dysfunction, Left

Topics: Amyloidosis; Aniline Compounds; Ethylene Glycols; Female; Heart Diseases; Humans; Male; Positron-Emission Tomography