Introduction: Cardiac amyloidosis (CA) is characterized by regional variations from base to apex in longitudinal strain (LS) using echocardiography. A relative apical sparing pattern of LS is reproductive method of differentiating CA from other causes of left ventricular hypertrophy. Methods: 40 consecutive patients suspected CA by echocardiography underwent thallium-201-chloride and 99mTc-PYP SPECT. We evaluated apical sparing on nuclear cardiology using the each percentage of left ventricular thickenings (17 segment) that were accumulated by quantitative gated SPECT. We calculated the relative apical thickening score (average apical thickening/average basal thickening + mid thickening). Results: Mean age of study population was 70 ± 12 years, and 70% were males. Six patients had biopsy proven systemic amyloidosis. The average score in the group of CA was 1.07 ± 0.25 and the other was 0.78 ± 0.44 (P = .034). Cutoff value of the apical thickening score was 0.82 and the sensitivity and specificity for diagnosing CA were 83% and 68%. Conclusions: In CA, the relative apical thickening score accumulated by SPECT expressed in a similar pattern to that of echocardiography. We may predict likelihood of CA by adding the score when we check SPECT image.
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