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Publications

Journal Article Epublish

PubMed: 40095730 DOI: 10.3390/jcm14051677

Thoracic Fat Pad Biopsy in Cardiac Amyloidosis: Diagnostic Yield in an Afro-Caribbean Population.

J Clin Med 14(5)

Authors: Cedrick Mvita Bakatubia, Romain Vergier, Mathilda Simeon, Nathan Buila Bimbi, Nathan Malka, Karima Lounaci, Maria Herrera Bethencourt, Karim Fard, Arnt Kristen, Rishika Banydeen, Astrid Monfort, Jocelyn Inamo, Andreas Müssigbrodt

Affiliations

  • Department of Cardiology, CHU Martinique (University Hospital of Martinique), 97200 Fort de France, France. Department of Cardiology, University Hospital of Kinshasa, Kinshasa 01302, Democratic Republic of the Congo.
  • Department of Cardiology, CHU Martinique (University Hospital of Martinique), 97200 Fort de France, France.
  • Department of Pathology, CHU Martinique (University Hospital of Martinique), 97200 Fort de France, France.
  • Department of Cardiology, University Hospital of Kinshasa, Kinshasa 01302, Democratic Republic of the Congo.
  • Clinique Ambroise Paré-Hartmann, 92200 Neuilly-sur-Seine, France. Hôtel-Dieu, AP-HP, 75004 Paris, France.
  • Caribbean Institute of Nuclear Imaging (ICIN), CHU Martinique (University Hospital of Martinique), 97200 Fort de France, France.
  • Department of Cardiology, Angiology, Respiratory Medicine, Medical University of Heidelberg, 69120 Heidelberg, Germany.
  • Clinical Research Unit, Department of Critical Care and Emergency Medicine, CHU Martinique (University Hospital of Martinique), 97200 Fort de France, France.
  • Cardiovascular Research Team (UR5_3 PC2E), University of the French West Indies (Université des Antilles), 97200 Fort de France, France.

Abstract

: Cardiac amyloidosis (CA) is associated with amyloid infiltration of the extra-cardiac tissue, which may occur in the early stages of the disease. This study evaluates the diagnostic utility of thoracic fat pad biopsy obtained during a pacemaker or ICD implantation as an alternative to the standard diagnostic criteria for systemic amyloidosis. : This exploratory, retrospective study included 27 patients with suspected or diagnosed CA who underwent pacemaker or defibrillator therapy. : Of these, 16 patients were confirmed to have CA (15 with technetium-labeled bisphosphonate bone scintigraphy and 1 with protein electrophoresis and echocardiographic findings) while 11 were confirmed to be CA-negative. The thoracic fat pad biopsy demonstrated a specificity of 100% but a sensitivity of only 31%. Among patients with transthyretin (ATTR)-CA, the sensitivity remained similarly low, at 27%. These results are consistent with prior findings on abdominal fat pad biopsy in ATTR-CA, highlighting the limited diagnostic yield of this method. : Thoracic fat pad biopsy cannot be recommended as a standard diagnostic tool for CA, particularly in ATTR-CA, due to its poor sensitivity. However, in AL (amyloid light-chain) amyloidosis, this minimally invasive procedure may aid diagnosis without additional invasive interventions.

MeSH

Biopsy, Amyloidosis, Amyloid, Radionuclide Imaging