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Thoracic fat pad biopsy in cardiac amyloidosis: diagnostic yield in an afro-caribbean population

Background/Objectives: 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 altern...

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Main Authors: Mvita Bakatubia, Cedrick (Author) , Vergier, Romain (Author) , Simeon, Mathilda (Author) , Buila Bimbi, Nathan (Author) , Malka, Nathan (Author) , Lounaci, Karima (Author) , Herrera Bethencourt, Maria (Author) , Fard, Karim (Author) , Kristen, Arnt (Author) , Banydeen, Rishika (Author) , Monfort, Astrid (Author) , Inamo, Jocelyn (Author) , Müssigbrodt, Andreas (Author)
Format: Article (Journal)
Language:English
Published: 1 March 2025
In: Journal of Clinical Medicine
Year: 2025, Volume: 14, Issue: 5, Pages: 1-13
ISSN:2077-0383
DOI:10.3390/jcm14051677
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm14051677
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/14/5/1677
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Author Notes: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 and Andreas Müssigbrodt
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Summary:Background/Objectives: 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. Methods: This exploratory, retrospective study included 27 patients with suspected or diagnosed CA who underwent pacemaker or defibrillator therapy. Results: 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. Conclusions: 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.
Item Description:Gesehen am 13.08.2025
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm14051677

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