{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T19:21:55Z","timestamp":1772133715045,"version":"3.50.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized disease, in which atrial fibrillation (AF) has been shown to be prevalent. Cardiac scintigraphy with technetium-99m-pyrophosphate (99mTc-PyP) labeled bone-seeking tracers is used to noninvasively make the diagnosis of ATTR-CA, based on ventricular myocardial uptake. Assessment of atrial wall uptake (AU) on 99mTc-PyP is currently not used in the clinical setting<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We analyzed a cohort of patients referred for 99mTc-PyP scan at a tertiary center to explore AU and associations between any and incident AF, ATTR-CA, and all-cause mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Among 580 patients included, 296 patients (51%) had a diagnosis of AF; 164 patients (28%) had scans consistent with ATTR-CA while 117 patients (20%) had AU. Of 117 patients with AU, 107 (91%) had any AF. In contrast, of 463 patients without AU 191(41%) had any AF. Of those with AU, 59\/117(50%) patients had a 99mTc-PyP diagnosis of ATTR-CA while 58\/117(50%) patients did not have such a diagnosis (\n              <jats:italic>P<\/jats:italic>\n              =1.00). Patients with AU had significantly more any AF (hazard ratio [HR], 1.03 [95% CI, 1.02\u20131.04];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), independent of ATTR-CA diagnosis and sex. On multivariable Cox proportional hazards analyses adjusting for age, AU, ATTR-CA diagnosis, sex, smoking, hypertension, diabetes, left ventricular ejection fraction, and coronary artery disease, both age (HR, 1.03 [95% CI, 1.02\u20131.04];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) and AU (HR, 2.68 [95% CI, 2.11\u20133.41];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) were independently associated with the development of any AF. Freedom from incident AF at 1-year was significantly lower in patients with AU, both in patients with and without ATTR-CA respectively (HR, 2.27 [95% CI, 1.37\u20133.78];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001 versus HR, 2.21 [95% CI, 1.46\u20133.34];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In a consecutive cohort of patients undergoing 99mTc-PyP scans, 20% had AU, which was statistically associated with any AF, independently of ATTR-CA diagnosis and sex. AU was associated with significantly lower freedom from incident AF at 1-year. Overlooking AU on 99mTc-PyP scans could potentially miss an earlier disease manifestation, or an additional risk factor for any\/incident AF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.121.013829","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T18:01:27Z","timestamp":1652810487000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Association Between Atrial Uptake on Cardiac Scintigraphy With Technetium-99m-Pyrophosphate Labeled Bone-Seeking Tracers and Atrial Fibrillation"],"prefix":"10.1161","volume":"15","author":[{"given":"Muzna","family":"Hussain","sequence":"first","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9316-866X","authenticated-orcid":true,"given":"Alison","family":"Krywanczyk","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2878-9061","authenticated-orcid":true,"given":"Eoin","family":"Donnellan","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trejeeve","family":"Martyn","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ossama Abou","family":"Hassan","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saqer","family":"Alkharabsheh","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Watson","sequence":"additional","affiliation":[{"name":"School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute for Experimental Medicine, Queen\u2019s University, Belfast, United Kingdom (C.W.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8335-735X","authenticated-orcid":true,"given":"W.H.","family":"Tang","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Kwon","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0794-3306","authenticated-orcid":true,"given":"Paul","family":"Cremer","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1736-2847","authenticated-orcid":true,"given":"Feixiong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, OH (F.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Kanj","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6831-8611","authenticated-orcid":true,"given":"Brian","family":"Griffin","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-7549","authenticated-orcid":true,"given":"Carmela","family":"Tan","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Rene","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. Collier)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazen","family":"Hanna","sequence":"additional","affiliation":[{"name":"Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, OH (M. Hussain., A.K., E.D., T.M., O.A.H., S.A., W.H.T., D.K., P. Cremer, M.K., B.G., C.T., E.R.R., M. Hanna, W.J., P. 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