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In Sweden, the Val30Met variant is the most prevalent. Val30Met presents in two phenotypes: an early-onset form dominated by polyneuropathy and a late-onset form frequently accompanied by cardiomyopathy. These phenotypes are associated with two amyloid fibril types. Type A fibrils, contain both fragmented and full-length transthyretin, whereas type B fibrils contain only full-length transthyretin. Fibril type has been linked to differences in cardiac tracer uptake on 99mTc-DPD scintigraphy. A total of 152 patients with confirmed variant transthyretin amyloidosis evaluated at Ume\u00e5 University Hospital, Sweden, were included. Age at disease onset and cardiac involvement, investigated by echocardiography, Troponin-T, and NT-proBNP, were assessed in relation to fibril type in abdominal fat and scintigraphic findings. Eighty-five patients had type A fibrils and sixty-seven had type B fibrils. Type A patients were older at diagnosis and had pathologic scintigraphies and more severe cardiac involvement. A subset of type B patients (15%) exhibited cardiac tracer uptake and had cardiac characteristics and age at disease onset similar to those with type A fibrils. Even though there was a strong correlation with findings in abdominal fat pad biopsies, results from 99mTc-DPD scintigraphy correlated better with clinical phenotype.<\/jats:p>","DOI":"10.1038\/s41598-026-43816-x","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T16:09:04Z","timestamp":1773677344000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac phenotype in hereditary transthyretin amyloidosis: correlations between fibril types and 99mTc-DPD uptake"],"prefix":"10.1038","volume":"16","author":[{"given":"Viktor","family":"L\u00f6fbacka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Wixner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Westermark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justina Damjanovic","family":"Vesterlund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Intissar","family":"Anan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Pilebro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"43816_CR1","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1136\/jnnp-2021-327909","volume":"93","author":"A Carroll","year":"2022","unstructured":"Carroll, A. et al. 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