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Comment & Response
June 2017

Prognosis Using Planar Imaging in Cardiac Amyloidosis

Author Affiliations
  • 1The Heart and Vascular Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
  • 2Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio
JAMA Cardiol. 2017;2(6):704. doi:10.1001/jamacardio.2016.5885

To the Editor We read with great interest the article by Castano et al1 and commend the authors on their continuous excellent work in this field. Technetium pyrophosphate scintigraphy has become a cornerstone of the noninvasive diagnostic algorithm in cardiac amyloidosis, and the authors used a retrospective cohort from 3 respected centers to conclude that a heart-to-contralateral (H/CL) ratio greater than 1.6 was associated with worse survival among patients with transthyretin amyloidosis (ATTR). However, there are some points to discuss before this particular number becomes widely used as a prognostic marker.

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