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PYP Scintigraphy in ATTR Cardiac Amyloidosis

The role of 99mTc-pyrophosphate scintigraphy in non-invasive diagnosis of transthyretin cardiac amyloidosis.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is PYP Scintigraphy in ATTR Cardiac Amyloidosis?

99mTc-pyrophosphate (PYP) scintigraphy is a key nuclear medicine technique for the non-invasive diagnosis of transthyretin (ATTR) cardiac amyloidosis. A Perugini grade 2–3 with a heart-to-contralateral ratio > 1.5 is diagnostic.

When monoclonal gammopathy is excluded, PYP scintigraphy can replace the need for biopsy. It is used alongside clinical features and genetic testing to differentiate hereditary (hATTR) and wild-type (ATTRwt) forms.

With the introduction of specific ATTR-targeted therapies such as tafamidis, early diagnosis significantly affects morbidity and mortality.

Symptoms

Heart failure (HFpEF)
Heart failure with aortic stenosis
Unexplained left ventricular hypertrophy
Multi-organ involvement
History of carpal tunnel syndrome
Bilateral tenosynovitis
History of spinal stenosis

Risk Factors

Advanced age (> 65)
Male sex
Family history
African ancestry (V122I)
Bilateral carpal tunnel
Spinal stenosis
Biceps tendon rupture

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Unexplained LVH
  • HFpEF with exercise limitation
  • Aortic stenosis in older adults
  • Amyloid suspicion on cardiac MRI
  • Multi-organ involvement
  • History of carpal tunnel with LVH

Treatment Methods

01
Tafamidis (TTR stabilizer)
02
Patisiran or inotersen (hATTR)
03
Volume control with diuretics
04
Arrhythmia management
05
Anticoagulation in atrial fibrillation
06
Multidisciplinary amyloid center follow-up
07
Genetic counseling for families

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kardiyoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.