{"id":6768,"date":"2025-12-07T23:15:28","date_gmt":"2025-12-07T19:15:28","guid":{"rendered":"https:\/\/kardio.az\/?p=6768"},"modified":"2025-12-07T23:15:29","modified_gmt":"2025-12-07T19:15:29","slug":"amilaidoz-x%c9%99st%c9%99l%c9%99rind%c9%99-yarana-bil%c9%99c%c9%99k-popeya-%c9%99lam%c9%99ti","status":"publish","type":"post","link":"https:\/\/kardio.az\/en\/hekimler-ucun\/amilaidoz-x%c9%99st%c9%99l%c9%99rind%c9%99-yarana-bil%c9%99c%c9%99k-popeya-%c9%99lam%c9%99ti\/","title":{"rendered":"Amilaidoz x\u0259st\u0259l\u0259rind\u0259 yarana bil\u0259c\u0259k Popeya \u0259lam\u0259ti"},"content":{"rendered":"<p>Popeye deformasiyas\u0131 n\u0259dir?<br>Popeye deformasiyas\u0131, cizgi filmi q\u0259hr\u0259man\u0131 Popeye-in h\u0259ddind\u0259n art\u0131q b\u00f6y\u00fck bisepsin\u0259 b\u0259nz\u0259y\u0259n \u015fi\u015fkin biseps \u0259z\u0259l\u0259si il\u0259 xarakteriz\u0259 olunur. Bu v\u0259ziyy\u0259t ad\u0259t\u0259n biseps \u0259z\u0259l\u0259sini \u00e7iyn\u0259 birl\u0259\u015fdir\u0259n biseps tendonunun uzun ba\u015f\u0131ndak\u0131 y\u0131rt\u0131qdan yaran\u0131r. Lakin b\u0259z\u0259n bu hal sistem x\u0259st\u0259likl\u0259ri zaman\u0131da yarana bilir. 2022 ci ildi Avropa Kardioloji C\u0259miyy\u0259tinin ayl\u0131q d\u0259rgisind\u0259 yay\u0131mlanm\u0131\u015f m\u0259qal\u0259d\u0259 bir ne\u00e7\u0259 Yapon v\u0259 \u0130span aliml\u0259ri bu haqda \u00e7ox maraql\u0131 ara\u015fd\u0131rma aparm\u0131\u015flar. Bu ara\u015fd\u0131rmalar\u0131n q\u0131sa icmal\u0131 original dild\u0259 t\u0259qdim olunur.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"369\" src=\"https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeye-2-1024x369.png\" alt=\"\" class=\"wp-image-6770\" srcset=\"https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeye-2-1024x369.png 1024w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeye-2-300x108.png 300w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeye-2-768x276.png 768w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeye-2-18x6.png 18w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeye-2.png 1456w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p><strong>Popeye&#8217;s sign, heart disease, and amyloidosis<\/strong><br><a href=\"https:\/\/jamanetwork.com\/searchresults?author=Toshiya+Nomura&amp;q=Toshiya+Nomura\" target=\"_blank\" rel=\"noreferrer noopener\">Toshiya\u00a0Nomura<sup>1<\/sup><\/a>;\u00a0<a href=\"https:\/\/jamanetwork.com\/searchresults?author=Fujio+Fujiki&amp;q=Fujio+Fujiki\" target=\"_blank\" rel=\"noreferrer noopener\">Fujio\u00a0Fujiki<sup>2<\/sup><\/a>;\u00a0<a href=\"https:\/\/jamanetwork.com\/searchresults?author=Mitsuharu+Ueda&amp;q=Mitsuharu+Ueda\" target=\"_blank\" rel=\"noreferrer noopener\">Mitsuharu\u00a0Ueda,\u00a0MD, PhD<sup>1<\/sup><\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><a href=\"https:\/\/academic.oup.com\/eurheartj\/article\/43\/31\/3000\/6617782\">Popeye\u2019s sign and transthyretin amyloidosis | European Heart Journal | Oxford Academic<\/a><\/p>\n\n\n\n<p>A 76-year-old man with a history of cervical open-door laminoplasty for ossification of the posterior longitudinal ligament presented to our hospital with a symptom of exertional dyspnoea. A 12-lead electrocardiogram revealed I-degree atrioventricular block (PQ interval 262\u2005ms), left axis deviation, and complete right bundle branch block (<em>Panel A<\/em>). A transthoracic echocardiogram indicated left ventricular hypertrophy with a maximum wall thickness of 17\u2005mm and a left ventricular ejection fraction of 61% (<em>Panel B1<\/em>). Strain echocardiogram using speckled tracking showed marked diminution of global longitudinal strain with apical sparing (<em>Panel B2<\/em>). Physical examination found subconjunctival hemorrhage in right eye, several purpuric lesions in upper extremities, and a large bulge on his left upper arm when he flexed his arm, so-called Popeye\u2019s sign, indicating a hallmark of biceps tendon rupture (see\u00a0<a href=\"https:\/\/oup.silverchair-cdn.com\/oup\/backfile\/Content_public\/Journal\/eurheartj\/43\/31\/10.1093_eurheartj_ehac330\/1\/ehac330_supplementary_data.mp4?Expires=1767733265&amp;Signature=1Xa1JWUDDk7HmlZjFqzqtjUy8GdAaTFyV1SQF4HN9X7jmri83ce~JoFsEvRhUQ2ieKXaDSyFrU04ZN5UVHGLlNR0nerO-yeR1-osIBUmmJkmlQHF8jbwxxZ~iQX4R~ArTJV1pGKHrQlqVzBf6ZGQsQBAnPmHb2wlc1iu7XvJR29Ix4OKG4MhbaNfWbKXqfCaJxh5IuT7~ZiZdDAuL1J1BW~4Y-ZSXC1UUAzvTPAuYiTlda486KND4YtCUYzT8VOJ1r02yrD6FIKe-sPp8SqhRpld9ywVxGmJafDQsWA31BLM~lnJxZTecG-AhgVmKaQHQD-NFUUKY45P8GMjzn1pfA__&amp;Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\">Supplementary material online<\/a>,\u00a0<em><a href=\"https:\/\/oup.silverchair-cdn.com\/oup\/backfile\/Content_public\/Journal\/eurheartj\/43\/31\/10.1093_eurheartj_ehac330\/1\/ehac330_supplementary_data.mp4?Expires=1767733265&amp;Signature=1Xa1JWUDDk7HmlZjFqzqtjUy8GdAaTFyV1SQF4HN9X7jmri83ce~JoFsEvRhUQ2ieKXaDSyFrU04ZN5UVHGLlNR0nerO-yeR1-osIBUmmJkmlQHF8jbwxxZ~iQX4R~ArTJV1pGKHrQlqVzBf6ZGQsQBAnPmHb2wlc1iu7XvJR29Ix4OKG4MhbaNfWbKXqfCaJxh5IuT7~ZiZdDAuL1J1BW~4Y-ZSXC1UUAzvTPAuYiTlda486KND4YtCUYzT8VOJ1r02yrD6FIKe-sPp8SqhRpld9ywVxGmJafDQsWA31BLM~lnJxZTecG-AhgVmKaQHQD-NFUUKY45P8GMjzn1pfA__&amp;Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\">Video S1<\/a><\/em>;\u00a0<em>Panel C<\/em>; arrow). A monoclonal component was not detected by serum and urine immune-electrophoresis and free light chain assays.\u00a0<sup>99m<\/sup>Tc-labelled bone scintigraphy showed grade 3 myocardial uptake (<em>Panel D<\/em>). Eventually, endomyocardial biopsy and genetic sequencing analysis of the transthyretin gene confirmed the patient as a wild-type transthyretin amyloidosis (<em>Panel E<\/em>). Popeye\u2019s sign is uncommon, but pivotal to diagnose transthyretin amyloidosis.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"575\" src=\"https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-1024x575.jpeg\" alt=\"\" class=\"wp-image-6771\" srcset=\"https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-1024x575.jpeg 1024w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-300x168.jpeg 300w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-768x431.jpeg 768w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-1536x863.jpeg 1536w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-2048x1150.jpeg 2048w, https:\/\/kardio.az\/wp-content\/uploads\/2025\/12\/popeya-3-18x10.jpeg 18w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p>Spain Research  do\u00fcnload PDF <a href=\"https:\/\/ruc.udc.es\/rest\/api\/core\/bitstreams\/0873af37-fbba-49f7-9da9-030e84ad780d\/content\"><a href=\"https:\/\/ruc.udc.es\/rest\/api\/core\/bitstreams\/0873af37-fbba-49f7-9da9-030e84ad780d\/content\"><a href=\"https:\/\/ruc.udc.es\/rest\/api\/core\/bitstreams\/0873af37-fbba-49f7-9da9-030e84ad780d\/content\">content<\/a><\/a><\/a><br>A 69-year-old man presented to our cardiology clinic troubled by breathlessness on exertion. He had a<br>history of hypertension, atrial fibrillation, and bilateral carpal tunnel syndrome. Physical examination<br>showed jugular venous distension, bilateral ankle oedema, and a bunching of the right biceps when he<br>flexed his arm\u2014so called Popeye\u2019s sign\u2014indicating rupture of the proximal biceps tendon (figure and<br>video); a rupture was confirmed by an ultrasound scan. Serum N-terminal-pro-B-type natriuretic peptide<br>was 7088 pg\/mL (normal range for patients aged 0\u201374 years is less than 125 pg\/mL). A 12-lead<br>electrocardiogram showed low voltage in the limb leads, as well as a pseudo-infarct pattern in the<br>precordial ones (appendix). A transthoracic echocardiogram showed left ventricular hypertrophy with a<br>maximum wall thickness of 20 mm and a left ventricular ejection fraction (LVEF) of 40%. Cardiac MRI<br>showed signs of myocardial infiltration. 99mTechnetium-3,3-diphosphono-1,2-propanodicarboxylic acid<br>(99mTc-DPD) scintigraphy showed grade 3 myocardial uptake (figure). Serum and urine<br>immunoelectrophoresis and free light chain assays ruled out a monoclonal component. Genetic<br>sequencing analysis of the transthyretin gene found no mutations. Tying all the findings together, a<br>diagnosis of heart failure secondary to wild-type transthyretin amyloid (ATTRwt) cardiomyopathy was<br>made. The patient was treated with a combination of diuretics\u2014namely, furosemide 80 mg twice a day,<br>hydrochlorothiazide 12\u30fb5 mg once a day, and spironolactone 100 mg once a day\u2014but he did not<br>respond well. He remained symptomatic with advanced functional impairment and persistent signs of<br>systemic venous congestion.<br>ATTRwt, previously known as senile systemic amyloidosis, is a disease that typically affects the heart<br>and tendons of elderly patients. A history of bilateral carpal tunnel syndrome or, less frequently,<br>spontaneous tendon rupture in a patient with heart failure and preserved or mildly depressed LVEF should<br>raise clinical suspicion of the condition. A definitive diagnosis of ATTRwt cardiomyopathy can be<br>confirmed non-invasively with a positive finding on 99mTc-DPD scintigraphy, together with the absence<br>of a monoclonal component in serum and urine samples, and a normal genetic sequencing analysis of the<br>transthyretin gene. Current therapy for patients with ATTRwt cardiomyopathy is limited, with diuretics<br>for relief of cardiac congestion being the mainstay of treatment. However, a recent randomised, placebo<br>controlled trial, published in September 2018, showed a significant reduction in the risk of death and<br>hospitalisation from cardiovascular causes in patients with ATTRwt cardiomyopathy treated with<br>tafamidis, a transthyretin stabilising agent. Tafamidis is expected to be available for clinical use in the<br>near future.<\/p>","protected":false},"excerpt":{"rendered":"<p>Popeye deformasiyas\u0131 n\u0259dir?Popeye deformasiyas\u0131, cizgi filmi q\u0259hr\u0259man\u0131 Popeye-in h\u0259ddind\u0259n art\u0131q b\u00f6y\u00fck bisepsin\u0259 b\u0259nz\u0259y\u0259n \u015fi\u015fkin biseps \u0259z\u0259l\u0259si il\u0259 xarakteriz\u0259 olunur. Bu v\u0259ziyy\u0259t ad\u0259t\u0259n biseps \u0259z\u0259l\u0259sini \u00e7iyn\u0259 birl\u0259\u015fdir\u0259n biseps tendonunun uzun ba\u015f\u0131ndak\u0131 y\u0131rt\u0131qdan yaran\u0131r. Lakin b\u0259z\u0259n bu hal sistem x\u0259st\u0259likl\u0259ri zaman\u0131da yarana bilir. 2022 ci ildi Avropa Kardioloji C\u0259miyy\u0259tinin ayl\u0131q d\u0259rgisind\u0259 yay\u0131mlanm\u0131\u015f m\u0259qal\u0259d\u0259 bir ne\u00e7\u0259 Yapon v\u0259&#8230;<\/p>","protected":false},"author":4,"featured_media":6769,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[26],"tags":[],"class_list":["post-6768","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hekimler-ucun"],"_links":{"self":[{"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/posts\/6768","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/comments?post=6768"}],"version-history":[{"count":1,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/posts\/6768\/revisions"}],"predecessor-version":[{"id":6772,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/posts\/6768\/revisions\/6772"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/media\/6769"}],"wp:attachment":[{"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/media?parent=6768"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/categories?post=6768"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kardio.az\/en\/wp-json\/wp\/v2\/tags?post=6768"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}