{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T23:42:48Z","timestamp":1773877368230,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1414,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>While 99mTc-pyrophosphate scintigraphy is clearly useful in diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM), it is necessary to know the pitfalls of this test for proper use. We present a rare case of concurrent ATTR-CM and amyloid light chain (AL) cardiomyopathy. The patient showed congestive heart failure with left ventricular hypertrophy. 99mTc-pyrophosphate scintigraphy revealed abnormal cardiac uptake of Grade 3, a typical feature for ATTR-CM. However, the patient showed renal impairment with proteinuria and the presence of monoclonal gammopathy, which rather suggested AL amyloidosis. Endomyocardial biopsy, immunohistochemistry, and proteomic analysis by laser microdissection with liquid chromatography-coupled tandem mass spectrometry were performed, which finally confirmed both ATTR-CM and AL cardiomyopathy. This case implicates the importance of combining examinations and precisely interpreting the results to diagnose cardiac amyloidosis accurately.<\/jats:p>","DOI":"10.1002\/ehf2.13773","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T04:58:13Z","timestamp":1642741093000},"page":"1474-1477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Step-by-Step Typing for the Accurate Diagnosis of Concurrent Light Chain and Transthyretin Cardiac Amyloidosis"],"prefix":"10.1093","volume":"9","author":[{"given":"Hidenori","family":"Moriyama","sequence":"first","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Kitakata","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7770-2519","authenticated-orcid":false,"given":"Jin","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidehiko","family":"Ikura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoaki","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayoshi","family":"Tasaki","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto ,","place":["Japan"]},{"name":"Department of Morphological and Physiological Sciences, Graduate School of Health Sciences, Kumamoto University , Kumamoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunta","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Showa General Hospital , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuharu","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medical Sciences, Kumamoto University , Kumamoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine , 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"2026012114171385000_ehf213773-bib-0001","doi-asserted-by":"crossref","first-page":"2872","DOI":"10.1016\/j.jacc.2019.04.003","article-title":"Transthyretin amyloid cardiomyopathy: JACC state-of-the-art review","volume":"73","author":"Ruberg","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026012114171385000_ehf213773-bib-0002","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1161\/CIR.0000000000000792","article-title":"Cardiac amyloidosis: evolving diagnosis and management: a scientific statement from the American Heart Association","volume":"142","author":"Kittleson","year":"2020","journal-title":"Circulation"},{"key":"2026012114171385000_ehf213773-bib-0003","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/ejhf.2140","article-title":"Diagnosis and treatment of cardiac amyloidosis. A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"23","author":"Garcia-Pavia","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2026012114171385000_ehf213773-bib-0004","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/pin.12902","article-title":"Human amyloidosis, still intractable but becoming curable: the essential role of pathological diagnosis in the selection of type-specific therapeutics","volume":"70","author":"Naiki","year":"2020","journal-title":"Pathol Int"},{"key":"2026012114171385000_ehf213773-bib-0005","article-title":"Avoiding catastrophe","volume":"14","author":"Witteles","journal-title":"Circ Heart Fail"},{"key":"2026012114171385000_ehf213773-bib-0006","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1161\/CIRCULATIONAHA.116.021612","article-title":"Nonbiopsy diagnosis of cardiac transthyretin amyloidosis","volume":"133","author":"Gillmore","year":"2016","journal-title":"Circulation"},{"key":"2026012114171385000_ehf213773-bib-0007","doi-asserted-by":"crossref","first-page":"3025","DOI":"10.1182\/blood-2014-06-580720","article-title":"Two types of amyloid in a single heart","volume":"124","author":"Mahmood","year":"2014","journal-title":"Blood"},{"key":"2026012114171385000_ehf213773-bib-0008","doi-asserted-by":"crossref","DOI":"10.1038\/s41408-019-0193-9","article-title":"Two types of amyloidosis presenting in a single patient: A case series","volume":"9","author":"Sidiqi","year":"2019","journal-title":"Blood Cancer J"},{"key":"2026012114171385000_ehf213773-bib-0009","first-page":"127","article-title":"Evidence of concurrent light chain and transthyretin cardiac amyloidosis in 2 patients","volume":"2","author":"Donnelly","year":"2020","journal-title":"JACC: CardioOncology"},{"key":"2026012114171385000_ehf213773-bib-0010","doi-asserted-by":"crossref","first-page":"4957","DOI":"10.1182\/blood-2009-07-230722","article-title":"Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens","volume":"114","author":"Vrana","year":"2009","journal-title":"Blood"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13773","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13773","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/2\/1474\/65375765\/eschf_9_2_1474.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/2\/1474\/65375765\/eschf_9_2_1474.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:20:35Z","timestamp":1769023235000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/2\/1474\/8326235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,21]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1,21]]},"published-print":{"date-parts":[[2022,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13773","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,4]]},"published":{"date-parts":[[2022,1,21]]},"assertion":[{"value":"2021-06-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}