Dobutamine stress echocardiography in orthotopic heart transplant recipients

Dérumeaux, Geneviève; Redonnet, M; Mouton-Schleifer, D; Bessou, Jean Paul; Cribier, Alain; Saoudi, Nadir; Köning, René; Soyer, R; Letac, B

doi:10.1016/0735-1097(95)00084-h

Cited by 86 publications

(36 citation statements)

References 26 publications

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“…5 Dobutamine stress echocardiography is useful 6 but, even in selected populations, 5% of patients referred for this test have inadequate acoustic window and 10% have nondiagnostic (sub-maximal negative) results. 6,7 Perfusion single photon emission computed tomography (SPECT) has a low sensitivity in patients with denervated heart and submaximal exercise test. 8 The addition of electrocardiographic gating increases the diagnostic accuracy of perfusion SPECT and provides reproducible information on left ventricular (LV) function.…”

Section: Introductionmentioning

confidence: 98%

Diagnostic and prognostic value of myocardial perfusion gated SPECT in orthotopic heart transplant recipients

Manrique

Bernard

Hitzel

et al. 2010

Journal of Nuclear Cardiology

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Section: Introductionmentioning

confidence: 98%

Diagnostic and prognostic value of myocardial perfusion gated SPECT in orthotopic heart transplant recipients

Manrique

Bernard

Hitzel

et al. 2010

Journal of Nuclear Cardiology

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“…61,62 When intimal thickening by intravascular ultrasound is taken as the "gold standard," dobutamine stress echocardiography shows specificities of up to 88%. 63,64 Moreover, a predictive value of dobutamine stress echocardiography for development of future CAV and outcome has been described.…”

Section: Dobutamine Stress Echocardiographymentioning

confidence: 99%

Cardiac Allograft Vasculopathy

2008

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Abstract-Cardiac allograft vasculopathy (CAV) continues to limit the long-term success of cardiac transplantation.Recent insights have underscored the fact that innate and adaptive immune responses are involved in the pathogenesis of CAV. Vascular lesions are the result of cumulative endothelial injuries induced both by alloimmune responses and by nonspecific insults (including ischemia-reperfusion injury, viral infections, and metabolic disorders) in the context of impaired repair mechanisms. Intravascular ultrasound is the most sensitive method for detection of CAV, and progressive intimal thickening in the first posttransplant year identifies patients at high risk for future cardiovascular events. Encouraging results with regard to the detection of CAV by noninvasive methods should be an incentive to apply routine noninvasive imaging during mid-to long-term follow-up. Improved immunosuppressive drugs, including mycophenolate mofetil and proliferation signal inhibitors, as well as statins (in part via immunomodulation), have beneficial effects on CAV progression, although there is still a need to confirm the impact of vasodilators in improving outcome after heart transplantation. Coronary revascularization for CAV is only palliative, with no long-term survival benefit. Three main strategies for CAV prevention are currently under investigation: inhibition of growth factors and cytokines, cell therapy, and tolerance induction. However, because individual responses to an allograft change over time, assays to monitor the recipient's immune response and individualized methods for therapeutic immune modulation are clearly needed. (Circulation. 2008;117:2131-2141.)

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“…Unlike with ESE, a number of studies have compared DSE vs ANG in children. 1,2,[5][6][7][8][9] One study of 70 pediatric heart transplant patients found the sensitivity and specificity values of DSE were 72% and 80%. 6 In another study of 102 pediatric heart transplant recipients, DSE had a sensitivity of 35% and specificity of 94%.…”

Section: Discussionmentioning

confidence: 98%