{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:33:03Z","timestamp":1793118783994,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council of Taiwan","doi-asserted-by":"publisher","award":["114-2314-B-002-197-MY3"],"award-info":[{"award-number":["114-2314-B-002-197-MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["113-N0062"],"award-info":[{"award-number":["113-N0062"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["114-N0071"],"award-info":[{"award-number":["114-N0071"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["112-N0048"],"award-info":[{"award-number":["112-N0048"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["113-N0002"],"award-info":[{"award-number":["113-N0002"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["114-N0079"],"award-info":[{"award-number":["114-N0079"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify myocardial blood flow (MBF) and myocardial flow reserve (MFR) using dynamic thallium-201 cadmium-zinc-telluride single-photon emission computed tomography (\u00b20\u00b9Tl CZT-SPECT), characterize microvascular dysfunction in transthyretin amyloid cardiomyopathy (ATTR-CM) versus individuals without obstructive coronary artery disease (CAD), and examine associations with disease markers. Post-tafamidis flow changes were explored secondarily.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-three participants were included (19 ATTR-CM, 14 without obstructive CAD). Dynamic \u00b20\u00b9Tl CZT-SPECT quantified MBF and MFR. Flow parameters were correlated with extracellular volume (ECV), biomarkers, echocardiographic indices, and 99mTc-pyrophosphate (PYP) uptake. Twelve patients underwent follow-up imaging after tafamidis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with ATTR-CM showed significantly reduced MBF and MFR, inversely correlated with ECV, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the E\/e\u2032 ratio (all P\u2009&amp;lt;\u2009.05), but not with PYP uptake. After tafamidis, PYP uptake decreased at the group level, whereas MFR changes were heterogeneous: 7 patients showed no reduction, while 5 showed a reduction. Patients with reduced MFR had greater increases in ECV, NT-proBNP, and E\/e\u2032 ratio. Relative changes in stress MBF and MFR were inversely associated with changes in ECV and E\/e\u2032 ratio, whereas relative changes in MFR were also inversely associated with changes in NT-proBNP (all P\u2009&amp;lt;\u2009.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dynamic CZT-SPECT demonstrated reduced MBF and MFR in ATTR-CM and associations with multimodality markers. Post-tafamidis findings were heterogeneous and exploratory, warranting larger prospective studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This is the first study to apply dynamic \u00b20\u00b9Tl CZT-SPECT for MBF quantification in ATTR-CM and to relate myocardial flow impairment to multimodality markers of disease burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag237","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:00:15Z","timestamp":1791216015000},"source":"Crossref","is-referenced-by-count":0,"title":["Myocardial blood flow changes assessed by dynamic cadmium-zinc-telluride-SPECT in patients with transthyretin amyloid cardiomyopathy treated with tafamidis: correlation with [99mTc]-pyrophosphate scintigraphy and cardiac 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