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Aims:  There has been a paradigm shift in diagnosis of cardiac transthyretin amyloidosis (ATTR) with non-invasive techniques including technetium-99m 3,3-diphosphono-1,2-propanodicarboxylic acid ( 99m Tc-DPD) bone scintigraphy. We evaluated structural and functional biventricular alterations by transthoracic echocardiography (TTE) and determined the correlation with  99m Tc-DPD tracer uptake in ATTR.   Materials and Methods:  ATTR patients (wild-type, hereditary or asymptomatic transthyretin [ TTR ] variant carriers) with  99m Tc-DPD and TTE were selected;  99m Tc-DPD uptake was analyzed quantitatively. TTE assessment of left ventricle (LV) and right ventricle (RV) parameters was performed.   Results:  Forty ATTR patients (wild-type  n  = 17; hereditary ATTR and  TTR  variant carriers  n  = 23; median age 68.8 ± 22 years) were included. TTE parameters displaying good correlation with  99m Tc-DPD tracer uptake included LV average wall thickness ( r  = 0.837), LV indexed mass (LVMI;  r  = 0.802), RV wall thickness ( r  = 0.610), average e' ( r  = −0.830), E/e' ratio ( r  = 0.786), LV global longitudinal strain (GLS;  r  = 0.714) and RV GLS ( r  = 0.632;  p  < 0.001 for all). Hereditary ATTR and  TTR  variant carriers without cardiac tracer uptake had normal echocardiographic parameters. Receiver operating characteristic curves demonstrated strong diagnostic accuracies for structural (LV wall thickness, LVMI and RV wall thickness; area under the curve (AUC) of 0.96 for all) and functional (LV and RV GLS; AUC of 0.86 and 0.88, respectively) parameters.   Conclusion:  Good correlations between TTE biventricular structural and functional parameters were demonstrated with quantitative  99m Tc-DPD uptake. Echocardiography may potentially assume a significant role in longitudinal follow-up for monitoring disease progression and for evaluating treatment response.

Correlation Between Quantitative Uptake of 99mTC-DPD and Echocardiographic Parameters in Cardiac ATTR: A Novel Follow-Up Strategy