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J Am Coll Cardiol, 2008; 51:1510, doi:10.1016/j.jacc.2008.01.016
© 2008 by the American College of Cardiology Foundation
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CORRESPONDENCE: LETTER TO THE EDITOR

Reply

Joseph B. Selvanayagam, MBBS (Hons), FRACP, DPhil, FESC*, Philip N. Hawkins, PhD, FRCP, FRCPath and Stefan Neubauer, MD, FRCP

* Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide 5042, Australia (Email: joseph.selva{at}fmc.sa.gov.au).

We welcome the interest of Drs. Rapezzi and colleagues in our article (1). We did not discuss radionuclide imaging of amyloid with tracers developed for bone scintigraphy because few data are available and because of constraints of space. Bone scintigraphy in amyloidosis has been evaluated systematically only in very small series (2), and there is no evidence as yet for a specific molecular interaction between bone-seeking isotopes and amyloid deposits. We believe that the suggestions by Dr. Rapezzi and colleagues that bone scintigraphy can facilitate the differential diagnosis of transthyretin and AL cardiac amyloidosis is therefore unsubstantiated in light of present knowledge but that further investigation of this interesting phenomenon is warranted.


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  1. Selvanayagam JB, Hawkins PN, Paul B, Myerson SG, Neubauer S. Evaluation and management of the cardiac amyloidosis J Am Coll Cardiol 2007;50:2101-2110.[Abstract/Free Full Text]
  2. Perugini E, Guidalotti PL, Salvi F, et al. Noninvasive etiologic diagnosis of cardiac amyloidosis using 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy J Am Coll Cardiol 2005;46:1076-1084.[Abstract/Free Full Text]

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Usefulness of 99mTc-DPD Scintigraphy in Cardiac Amyloidosis
Claudio Rapezzi, Pierluigi Guidalotti, Fabrizio Salvi, Letizia Riva, and Enrica Perugini
J. Am. Coll. Cardiol. 2008 51: 1509-1510. [Full Text] [PDF]




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