{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T10:01:47Z","timestamp":1780999307785,"version":"3.54.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":135,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of heart failure, yet data guiding surveillance strategies in high-risk individuals remain limited. This study evaluated the incidence, imaging patterns, and clinical predictors of SPECT\/CT conversion among patients undergoing serial Tc-99m PYP\/HMDP imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 106 patients who underwent repeat Tc-99m PYP or HMDP cardiac SPECT\/CT between 2018 and 2025. Patients with a positive initial scan or repeat imaging within less than 12 months were excluded. Conversion was defined as a new Perugini grade \u22651 with any myocardial radiotracer uptake on follow-up. Clinical characteristics, biomarkers, genetic testing, and extracardiac biopsy findings were analysed. Univariable and multivariable Cox regression identified predictors of conversion. Over a mean follow-up of 3.2 years, 14 patients (13.2%) showed imaging conversion. Echocardiographic parameters and absolute biomarker levels were comparable between groups; however, a \u226530% rise in NT-proBNP was more frequent among converters (71.4% vs. 38.1%, P = 0.018). On univariable analysis, hypertension was associated with a lower hazard of conversion (HR 0.27; P = 0.023), while co-occurrence of carpal tunnel syndrome and spinal stenosis was associated with a significantly higher hazard (HR 3.90; P = 0.024). In multivariable analysis adjusted for age and sex, this musculoskeletal phenotype remained independently associated with conversion (adjusted HR 5.95; P = 0.019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combined presence of carpal tunnel syndrome and spinal stenosis identifies a high-risk phenotype for future imaging conversion. These exploratory findings support serial amyloid SPECT\/CT for surveillance and highlight the value of musculoskeletal comorbidities in refining risk stratification for ATTR-CA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyag089","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:43:30Z","timestamp":1778845410000},"source":"Crossref","is-referenced-by-count":0,"title":["Yield and predictors of conversion on serial amyloid nuclear SPECT\/CT in at-risk populations for transthyretin cardiac amyloidosis"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2915-2510","authenticated-orcid":false,"given":"Saberio","family":"Lo Presti","sequence":"first","affiliation":[{"name":"Section of Advanced Cardiac Imaging, Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8540-1916","authenticated-orcid":false,"given":"Amr","family":"Darwish","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Fairview Hospital , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5692-2299","authenticated-orcid":false,"given":"Zoran","family":"Popovic","sequence":"additional","affiliation":[{"name":"Section of Advanced Cardiac Imaging, Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6501-6845","authenticated-orcid":false,"given":"Mohamed","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Ain Shams University , Cairo ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0954-1367","authenticated-orcid":false,"given":"Bryan","family":"Abadie","sequence":"additional","affiliation":[{"name":"Section of Advanced Cardiac Imaging, Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Wang","sequence":"additional","affiliation":[{"name":"Section of Advanced Cardiac Imaging, Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5642-2112","authenticated-orcid":false,"given":"Wael","family":"Jaber","sequence":"additional","affiliation":[{"name":"Section of Advanced Cardiac Imaging, Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Hanna","sequence":"additional","affiliation":[{"name":"Section of Heart Failure and Cardiac Transplant, Department of Cardiovascular Medicine, Heart, Vascular, & Thoracic Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"2026060905370347700_qyag089-B1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.jcmg.2024.10.011","article-title":"The last decade in cardiac amyloidosis: advances in understanding pathophysiology, diagnosis and quantification, prognosis, treatment strategies, and monitoring response","volume":"18","author":"Fontana","year":"2025","journal-title":"JACC Cardiovasc 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