Single photon emission computed tomography myocardial perfusion imaging to detect cardiac allograft vasculopathy Journal Article

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Authors: Thompson, D.; Koster, M. J.; Wagner, R. H.; Heroux, A; Barron, J. T.
Article Title: Single photon emission computed tomography myocardial perfusion imaging to detect cardiac allograft vasculopathy
Abstract: AIMS: Cardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality in cardiac transplant recipients. This study evaluates the usefulness of single photon emission computed tomography (SPECT) and various SPECT-derived diastolic variables to detect CAV in heart transplant patients. METHODS AND RESULTS: A retrospective review of 141 SPECT studies with corresponding coronary angiograms within 12 months was performed on 99 transplant recipients. Diastolic function was assessed using computer-derived measures of peak filling rate (PFR), time to peak filling rate (TPFR), and mean first one-third filling rate (MFR/3). Angiography identified CAV in 53 of the 141 studies (38%). Of the 53, SPECT identified 7 with reversible myocardial defects (sensitivity 13%) and stress-induced electrocardiographic evidence of ischaemia was seen in one patient (sensitivity 2%). SPECT imaging was negative in 86 of the 88 negative coronary angiograms (specificity 98%). The positive predictive value and negative predictive value were 78 and 65%, respectively. If a more stringent definition of CAV was used (gt;/=70% stenosis), the sensitivity and specificity were unchanged (14 and 98%, respectively). There was no statistical difference in diastolic variables between patients with or without angiographic evidence of CAV in regard to PFR (3.57 +/- 1.14 vs. 3.18 +/- 1.21 EDV/s, P = 0.90), TPFR (149 +/- 32 vs. 153 +/- 43 ms, P = 0.33), or MFR/3 (1.37 +/- 0.43 vs. 1.27 +/- 0.42 EDV/s, P = 0.94). CONCLUSION: Adenosine stress/rest technetium-99m tetrofosmin-gated SPECT is not a sensitive test for detection of CAV in heart transplant recipients. Diastolic dysfunction, as assessed by SPECT, was not shown to be associated with development of CAV.
Journal Title: European heart journal cardiovascular Imaging
Volume: 13
Issue: 3
ISSN: 2047-2412; 2047-2404
Publisher: Unknown  
Journal Place: England
Date Published: 2012
Start Page: 271
End Page: 275
Language: eng
DOI/URL:

10.1093/ejechocard/jer270
Notes: LR: 20161125; JID: 101573788; 2011/12/07 06:00 [entrez]; 2011/12/07 06:00 [pubmed]; 2012/08/24 06:00 [medline]; ppublish