{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:57:51Z","timestamp":1784357871792,"version":"3.55.0"},"reference-count":152,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T00:00:00Z","timestamp":1735257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer","award":["69901823"],"award-info":[{"award-number":["69901823"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Amyloidosis is a rare pathology characterized by protein deposits in various organs and tissues. Cardiac amyloidosis (CA) can be caused by various protein deposits, but transthyretin amyloidosis (ATTR) and immunoglobulin light chain (AL) are the most frequent pathologies. Protein misfolding can be induced by several factors such as oxidative stress, genetic mutations, aging, chronic inflammation, and neoplastic disorders. In ATTR cardiomyopathy (ATTR-CM), the amyloid fibrils can be found in the myocardium interstitial space and are associated with arrhythmias and heart failure. In pathological situations, the transthyretin (TTR) configuration is destroyed by proteolytic action, leading to monomers that further misfold and aggregate to form the amyloid fibrils. 99mTc-Pyrophosphate (99m-Tc-PYP), 99mTc 3,3-diphosphono-1,2-propanodicarboxylic acid (99m-Tc-DPD) and 99m-Tc hydroxy-methylene-Dyphosphonate (99m-Tc-HMDP) are used to detect myocardium amyloid deposits due to their ability to detect calcium ions that are present in the amyloid fibrils through dystrophic calcification. ATTR-CM therapy acts on different stages of the amyloidogenic process, including liver TTR synthesis, TTR tetramer destabilization, and misfolding of the monomers. The main aim of this narrative review is to present ATTR-CM, starting with molecular changes regarding the protein misfolding process and radionuclide aspects and finishing with pharmacological approaches.<\/jats:p>","DOI":"10.3390\/ijms26010146","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T09:13:32Z","timestamp":1735290812000},"page":"146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["From Molecular to Radionuclide and Pharmacological Aspects in Transthyretin Cardiac Amyloidosis"],"prefix":"10.3390","volume":"26","author":[{"given":"Silviu Marcel","family":"Stanciu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxandra","family":"Jurcut","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Institute of Cardiovascular Diseases \u201cProf CC Iliescu\u201d, 022322 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruxandra","family":"Dragoi Galrinho","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Surgery, University and Emergency Hospital, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantin","family":"Stefani","sequence":"additional","affiliation":[{"name":"Department I of Family Medicine and Clinical Base, \u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Miricescu","sequence":"additional","affiliation":[{"name":"Discipline of Biochemistry, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Ruxandra","family":"Rusu","sequence":"additional","affiliation":[{"name":"Discipline of Anatomy, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3520-5025","authenticated-orcid":false,"given":"Georgiana Sabina","family":"Prisacariu","sequence":"additional","affiliation":[{"name":"Clinic of Nuclear Medicine Central University Emergency Military Hospital \u201cDr Carol Davila\u201d, 10825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-3210","authenticated-orcid":false,"given":"Raluca","family":"Mititelu","sequence":"additional","affiliation":[{"name":"Clinic of Nuclear Medicine Central University Emergency Military Hospital \u201cDr Carol Davila\u201d, 10825 Bucharest, Romania"},{"name":"Department of Nuclear Medicine, University of Medicine and Pharmacy Carol Davila, 030147 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1159\/000506696","article-title":"The Pathology of Amyloidosis in Classification: A Review","volume":"143","author":"Picken","year":"2020","journal-title":"Acta Haematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.jacc.2016.06.053","article-title":"AL (Light-Chain) Cardiac Amyloidosis: A Review of Diagnosis and Therapy","volume":"68","author":"Falk","year":"2016","journal-title":"J. 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