{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T18:45:21Z","timestamp":1794336321826,"version":"4.9.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"24","license":[{"start":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T00:00:00Z","timestamp":1496966400000},"content-version":"vor","delay-in-days":94,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Congo red staining of an endomyocardial biopsy is the diagnostic gold-standard in suspected cardiac amyloidosis (CA), but the procedure is associated with the risk, albeit small, of serious complications, and delay in diagnosis due to the requirement for technical expertise. In contrast, abdominal fat pad fine needle aspiration (FPFNA) is a simple, safe and well-established procedure in systemic amyloidosis, but its diagnostic sensitivity in patients with suspected CA remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We assessed the diagnostic sensitivity of FPFNA in 600 consecutive patients diagnosed with CA [216 AL amyloidosis, 113 hereditary transthyretin (ATTRm), and 271 wild-type transthyretin (ATTRwt) amyloidosis] at our Centre. Amyloid was detected on Congo red staining of FPFNAs in 181\/216 (84%) patients with cardiac AL amyloidosis, including 100, 97, and 78% of those with a large, moderate, and small whole-body amyloid burden, respectively, as assessed by serum amyloid P (SAP) component scintigraphy (P &amp;lt; 0.001); the deposits were successfully typed as AL by immunohistochemistry in 102\/216 (47%) cases. Amyloid was detected in FPFNAs of 51\/113 (45%) patients with ATTRm CA, and only 42\/271 (15%) cases with ATTRwt CA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>FPFNA has reasonable diagnostic sensitivity in cardiac AL amyloidosis, particularly in patients with a large whole-body amyloid burden. Although the diagnostic sensitivity of FPFNA is substantially lower in transthyretin CA, particularly ATTRwt, it may nevertheless sometimes obviate the need for endomyocardial biopsy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehx047","type":"journal-article","created":{"date-parts":[[2017,1,30]],"date-time":"2017-01-30T13:27:49Z","timestamp":1485782869000},"page":"1905-1908","source":"Crossref","is-referenced-by-count":191,"title":["Diagnostic sensitivity of abdominal fat aspiration in cardiac amyloidosis"],"prefix":"10.1093","volume":"38","author":[{"given":"Candida Cristina","family":"Quarta","sequence":"first","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"},{"name":"2Istituto di Cardiologia, Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Alma Mater Studiorum Universit\u00e0 di Bologna, Via Massarenti 9, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Gonzalez-Lopez","sequence":"additional","affiliation":[{"name":"3Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Manuel de Falla 1, 28222, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A.","family":"Gilbertson","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichola","family":"Botcher","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Rowczenio","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviva","family":"Petrie","sequence":"additional","affiliation":[{"name":"4Eastman Dental Institute, University College London, 256 Grays Inn Rd, WC1X 8LD, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Rezk","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taryn","family":"Youngstein","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shameem","family":"Mahmood","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajitha","family":"Sachchithanantham","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen J.","family":"Lachmann","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Fontana","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol J.","family":"Whelan","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh D.","family":"Wechalekar","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip N.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian D.","family":"Gillmore","sequence":"additional","affiliation":[{"name":"1National Amyloidosis Centre, Division of Medicine, UCL, Royal Free Hospital, Rowland Hill Street, NW3 2PF, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,3,7]]},"reference":[{"key":"2022102605222199100_ehx047-B1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1136\/ard.22.4.256","article-title":"Amyloidosis in rheumatoid arthritis investigated by means of rectal biopsy","volume":"22","author":"Arapakis","year":"1963","journal-title":"Ann Rheum Dis"},{"key":"2022102605222199100_ehx047-B2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/00000441-196605000-00001","article-title":"Value of rectal biopsy in the diagnosis of primary systemic amyloidosis","volume":"251","author":"Kyle","year":"1966","journal-title":"Am J Med Sci"},{"key":"2022102605222199100_ehx047-B3","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1002\/art.1780360518","article-title":"Labial salivary gland biopsy is a reliable test for the diagnosis of primary and secondary amyloidosis. A prospective clinical immunohistologic study in 59 patients","volume":"36","author":"Hachulla","year":"1993","journal-title":"Arthritis Rheum"},{"key":"2022102605222199100_ehx047-B4","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1002\/dc.10370","article-title":"Fine-needle aspiration of abdominal fat pad for amyloid detection: a clinically useful test?","volume":"30","author":"Ansari-Lari","year":"2004","journal-title":"Diagn Cytopathol"},{"key":"2022102605222199100_ehx047-B5","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/j.amjmed.2015.05.039","article-title":"Noninvasive identification of ATTRwt cardiac amyloid: the re-emergence of nuclear cardiology","volume":"128","author":"Maurer","year":"2015","journal-title":"Am J Med"},{"key":"2022102605222199100_ehx047-B6","first-page":"665","article-title":"Amyloidosis (AL): clinical and laboratory features in 229 cases","volume":"58","author":"Kyle","year":"1983","journal-title":"Mayo Clin Proc"},{"key":"2022102605222199100_ehx047-B7","doi-asserted-by":"crossref","first-page":"3420","DOI":"10.1182\/blood-2012-12-473066","article-title":"A European collaborative study of treatment outcomes in 346 patients with cardiac stage III AL amyloidosis","volume":"121","author":"Wechalekar","year":"2013","journal-title":"Blood"},{"key":"2022102605222199100_ehx047-B8","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1056\/NEJM199702133360703","article-title":"Variant-sequence transthyretin (isoleucine 122) in late-onset cardiac amyloidosis in black Americans","volume":"336","author":"Jacobson","year":"1997","journal-title":"N Engl J Med"},{"key":"2022102605222199100_ehx047-B9","doi-asserted-by":"crossref","first-page":"e000098.","DOI":"10.1161\/JAHA.113.000098","article-title":"Senile systemic amyloidosis: clinical features at presentation and outcome","volume":"2","author":"Pinney","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"2022102605222199100_ehx047-B10","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jchf.2013.11.004","article-title":"Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction","volume":"2","author":"Mohammed","year":"2014","journal-title":"JACC Heart Fail"},{"key":"2022102605222199100_ehx047-B11","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/978-1-60761-389-3_15","volume-title":"Amyloid and Related Disorders: Surgical Pathology and Clinical Correlations","author":"Bijzet","year":"2012"},{"key":"2022102605222199100_ehx047-B12","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1016\/j.amjcard.2014.02.030","article-title":"Yield of noncardiac biopsy for the diagnosis of transthyretin cardiac amyloidosis","volume":"113","author":"Fine","year":"2014","journal-title":"Am J Cardiol"},{"key":"2022102605222199100_ehx047-B13","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1002\/art.21902","article-title":"Diagnostic accuracy of subcutaneous abdominal fat tissue aspiration for detecting systemic amyloidosis and its utility in clinical practice","volume":"54","author":"van","year":"2006","journal-title":"Arthritis Rheum"},{"key":"2022102605222199100_ehx047-B14","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1056\/NEJM199008233230803","article-title":"Evaluation of systemic amyloidosis by scintigraphy with 123I-labeled serum amyloid P component","volume":"323","author":"Hawkins","year":"1990","journal-title":"N Engl J Med"},{"key":"2022102605222199100_ehx047-B15","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1007\/s00259-010-1642-7","article-title":"Usefulness and limitations of 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid scintigraphy in the aetiological diagnosis of amyloidotic cardiomyopathy","volume":"38","author":"Rapezzi","year":"2011","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2022102605222199100_ehx047-B16","doi-asserted-by":"crossref","first-page":"E2403","DOI":"10.1002\/humu.22619","article-title":"Online registry for mutations in hereditary amyloidosis including nomenclature recommendations","volume":"35","author":"Rowczenio","year":"2014","journal-title":"Hum Mutat"},{"key":"2022102605222199100_ehx047-B17","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":"2022102605222199100_ehx047-B18","first-page":"160","volume-title":"Amyloid and Amyloidosis 1998","author":"Tennent","year":"1999"},{"key":"2022102605222199100_ehx047-B19","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/BF01254559","article-title":"Imaging amyloidosis with radiolabelled SAP","volume":"22","author":"Hawkins","year":"1995","journal-title":"Eur J Nucl Med"},{"key":"2022102605222199100_ehx047-B20","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s002590050273","article-title":"Serum amyloid P component scintigraphy in familial amyloid polyneuropathy: regression of visceral amyloid following liver transplantation","volume":"25","author":"Rydh","year":"1998","journal-title":"Eur J Nucl Med"},{"key":"2022102605222199100_ehx047-B21","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1093\/eurheartj\/ehr383","article-title":"Cardiac phenotype and clinical outcome of familial amyloid polyneuropathy associated with transthyretin alanine 60 variant","volume":"33","author":"Sattianayagam","year":"2012","journal-title":"Eur Heart J"},{"key":"2022102605222199100_ehx047-B22","doi-asserted-by":"crossref","first-page":"2733","DOI":"10.1093\/eurheartj\/ehu284","article-title":"2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC)","volume":"35","author":"Authors\/Task Force members","year":"2014","journal-title":"Eur Heart J"},{"key":"2022102605222199100_ehx047-B23","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":["European Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/38\/24\/1905\/46631983\/eurheartj_38_24_1905.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/38\/24\/1905\/46631983\/eurheartj_38_24_1905.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T05:29:13Z","timestamp":1666762153000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartj\/article\/38\/24\/1905\/3865531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,7]]},"references-count":23,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2017,3,7]]},"published-print":{"date-parts":[[2017,6,21]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/ehx047","relation":{},"ISSN":["0195-668X","1522-9645"],"issn-type":[{"value":"0195-668X","type":"print"},{"value":"1522-9645","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,6,21]]},"published":{"date-parts":[[2017,3,7]]}}}