Myocardial perfusion imaging for cardiac allograft vasculopathy assessment: Evidence grows, but questions remain

Acharya, Deepak; Rajapreyar, Indranee

doi:10.1007/s12350-017-1116-4

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…The diagnostic power of SPECT imaging for CAV is variable and appears to be dependent on both the class of the radiotracer used and the method of cardiac stress [ 11 , 80 , 81 ]. Previously, Ciliberto et al reported a sensitivity of 67% and a specificity of 100% for the diagnosis of CAV in 50 HTx patients, utilizing exercise thallium scintigraphy [ 82 ].…”

Section: Non-invasive Modalitiesmentioning

confidence: 99%

“…The gold-standard diagnostic technique is invasive coronary angiography (ICA), either with or without intravascular ultrasound (IVUS), which carries a risk of contrast-related kidney injury and procedure-related vascular lesions [ 10 ]. Often, however, transplant patients with normal ICA have been found to have a high prevalence of CAV on autopsy [ 11 ]. Over the past decades, non-invasive modalities, spanning from rest echocardiography to nuclear imaging, have been investigated to improve the early detection of CAV [ 1 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Kamel,

Scalia,

Badr

et al. 2024

JCDD

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Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity. However, these tests are invasive and are unable to visualize and evaluate coronary microcirculation. Increasing evidence for non-invasive surveillance techniques assessing both epicardial and microvascular components of CAV may help improve early detection. These include computed tomography coronary angiography (CTCA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and vasodilator stress myocardial contrast echocardiography perfusion imaging. This review summarizes the current state of diagnostic modalities and their utility and prognostic value for CAV and also evaluates emerging tools that may improve the early detection of this complex disease.

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Section: Non-invasive Modalitiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Kamel,

Scalia,

Badr

et al. 2024

JCDD

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“…Исследования диагностических возможностей ОФЭКТ-изображений миокардиальной перфузии в выявлении патологии сердечного трансплантата на сегодняшний момент чаще всего проводится с использованием стресс-тестов. При этом авторы анализируют, как правило, только распределение перфузии в миокарде, сравнивая данные исследования в покое и после нагрузки [2,3]. Между тем уже около четверти века в кардиологии развит метод перфузионной ОФЭКТ, синхронизированной с ЭКГ, который позволяет не только оценивать изменения объемов левого желудочка (ЛЖ) и правого желудочка (ПЖ), их фракции выброса (ФВ), диастолическую функцию и скоростные параметры изгнания, но и получать изображения движения, систолического утолщения и асинхронии миокарда обоих желудочков по сегментам и в цифровых значениях [4].…”

Section: Introductionunclassified

Simultaneous visualization of changes in perfusion and myocardial function of a transplanted heart in emergency cardiology

Ostroumov,

Migunova,

Vovchenko

et al. 2024

Transplantologiâ (Mosk.)

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Introduction. In conditions of the Emergency Cardiology Department, a timely and differential diagnosis of myocardial pathology is especially important in the absence of visible focal changes and significant coronary artery stenosis. This group of patients includes recipients of a transplanted heart, when it is difficult to count on the high sensitivity of perfusion images alone. This can be explained by the diffuse, balanced distribution of ischemia.Objective. To present the possibilities of perfusion myocardial single photon emission computed tomography synchronized with electrocardiography for a detailed assessment of the functional condition of both ventricles of the transplanted heartMaterial and methods. We have presented three clinical case reports of the patients with different pathology of the transplanted heart who referred themselves to the emergency cardiology clinic and underwent electrocardiographysynchronized perfusion myocardial single photon emission computed tomography for diagnostic purposes.Results. In all the cases presented, the radionuclide study influenced making the diagnosis and changing the treatment tactics. In the first case, it was possible to identify focal myocardial changes, for which coronary angiography and percutaneous coronary intervention with thromboextraction were immediately performed. In the second case, the image analysis reflecting the function of the myocardium (polar maps of wall movement and systolic thickening) allowed us to note a low efficacy of treatment for the transplanted heart rejection. In the third clinical case, the initial single photon emission computed tomography suggested the inflammatory nature of changes in the myocardium, which was verified by the results of endomyocardial biopsy.Conclusion. In the presented clinical cases, the urgently performed electrocardiography-synchronized perfusion myocardial single photon emission computed tomography made it possible to perform invasive interventions in time and thereby contribute to the recovery of the graft functional state and patient's condition improvement.

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Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2019: Single-photon emission computed tomography

Hage

AlJaroudi

2020

Journal of Nuclear Cardiology

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Myocardial perfusion imaging for cardiac allograft vasculopathy assessment: Evidence grows, but questions remain

Cited by 3 publications

References 17 publications

Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Simultaneous visualization of changes in perfusion and myocardial function of a transplanted heart in emergency cardiology

Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2019: Single-photon emission computed tomography

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