SPECT myocardial perfusion imaging in liver transplantation candidates

Duvall, W. Lane; Singhvi, Aditi; Henzlova, Milena J.

doi:10.1007/s12350-018-1388-3

Cited by 17 publications

(12 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Currently, there is no consensus regarding cardiovascular testing in pre-LT patients, which is likely due to the heterogeneity of the published data and how CAD is defined. Contrary to the perfusion data presented by Duvall et al, 5 small studies of anatomical imaging have reported a higher prevalence of CAD. In a study of 85 low-CAD-risk patients with ESLD, Kemmer et al reported a prevalence of prognostically significant coronary artery calcium score (CAC) of [ 400 to be present in 19 (22%) with a prevalence of obstructive CAD on ICA to be 26%.…”

Section: Among Pre-lt Patients Without Known Cad Butcontrasting

confidence: 83%

“…In this issue of the Journal, Duvall et al summarized their 10-year experience of cardiovascular risk stratification using SPECT MPI, in patients awaiting LT. 5 The authors evaluated clinical and SPECT MPI data from 34,551 patients who underwent stress MPI between 2004 and 2014. Of these, 2500 patients were evaluated pre-LT.…”

Section: See Related Article Pp 254-265mentioning

confidence: 99%

See 1 more Smart Citation

Low yield of routine stress testing in patients awaiting liver transplantation

Akincioğlu

Malhotra

2020

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

Section: Among Pre-lt Patients Without Known Cad Butcontrasting

confidence: 83%

Section: See Related Article Pp 254-265mentioning

confidence: 99%

Low yield of routine stress testing in patients awaiting liver transplantation

Akincioğlu

Malhotra

2020

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

“…Nonetheless, a trend towards higher rates of peri-operative ischemic complications was noted in patients with a positive SPECT study. These findings were also confirmed in another study by Duvall et al [35].…”

Section: Myocardial Perfusion Imaging (Mpi)supporting

confidence: 83%

Preoperative Evaluation of Coronary Artery Disease in Liver Transplant Candidates: Many Unanswered Questions in Clinical Practice

et al. 2021

View full text Add to dashboard Cite

Cardiovascular (CV) complications represent the first non-graft-related cause of death and the third overall cause of death among patients undergoing liver transplantation (LT). History of coronary artery disease is related to increased CV mortality following LT. Although it is of paramount importance to stratify CV risk in pre-LT patients, there is no consensus regarding the choice of the optimal non-invasive cardiac imaging test. Algorithms proposed by scientific associations include non-traditional risk factors, which are associated with increased cardiac risk profiles. Thus, an individualized pre-LT evaluation protocol should be followed. As the average age of patients undergoing LT and the number of candidates continue to rise, the “3 W” questions still remain unanswered, Who, Which and When? Who should be screened for coronary artery disease (CAD), which screening modality should be used and when should the asymptomatic waitlisted patients repeat cardiac evaluation? Prospective studies with large sample sizes are warranted to define an algorithm that can provide better risk stratification and more reliable survival prediction.

show abstract

“…This high rate of normal perfusion studies is similar to a recent large cohort (n = 2500) of SPECT MPI studies performed for OLT cardiac risk evaluation. (24) The concern with this modality for assessing cardiovascular risk in ESLD is 2-fold: fig. 5.…”

Section: Discussionmentioning

confidence: 99%

Coronary Computed Tomography Angiography Demonstrates a High Burden of Coronary Artery Disease Despite Low‐Risk Nuclear Studies in Pre–Liver Transplant Evaluation

et al. 2020

View full text Add to dashboard Cite

We investigated the presence and severity of coronary artery disease (CAD) in orthotopic liver transplantation (OLT) candidates using coronary artery calcium score (CACS) and coronary computed tomography angiography (CCTA) as compared with the prevalence of normal and abnormal single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). A total of 140 prospective OLT candidates without known CAD underwent coronary artery calcium (CAC) scans with (n = 77) or without CCTA and coronary computed tomography angiography-derived fractional flow reserve (FFR CT ; n = 57) using a dual-source computed tomography (CT) and were followed for 2.6 ± 1.4 years. Coronary plaque was quantified using the segment-involvement score (SIS) and segment stenosis score (SSS). The mean age was 59 ± 6 years, and 65.0% of patients were male. Mean Agatston CACS was 367 ± 653, and 15.0% of patients had CACSs of 0; 83.6% received a SPECT MPI, of which 95.7% were interpreted as normal/probably normal. By CCTA, 9.1% had obstructive CAD (≥70% stenosis), 67.5% had nonobstructive CAD, and 23.4% had no CAD. Nonobstructive CAD was diffuse with mean SIS 3.0 ± 2.9 and SSS 4.5 ± 5.4. Only 14 patients had high risk-findings (severe 3v CAD, n = 4, CACS >1000 n = 10) that prompted X-ray angiography in 3 patients who had undergone CCTA, resulting in revascularization of a high-risk obstruction in 1 patient who had a normal SPECT study. Patients with end-stage liver disease have a high prevalence of nonobstructive CAD by CCTA, which is undiagnosed by SPECT MPI, potentially underestimating cardiovascular risk. Deferring X-ray angiography unless high-risk CCTA findings are present is a potential strategy for avoiding unnecessary X-ray angiography.

show abstract

SPECT myocardial perfusion imaging in liver transplantation candidates

Cited by 17 publications

References 33 publications

Low yield of routine stress testing in patients awaiting liver transplantation

Low yield of routine stress testing in patients awaiting liver transplantation

Preoperative Evaluation of Coronary Artery Disease in Liver Transplant Candidates: Many Unanswered Questions in Clinical Practice

Coronary Computed Tomography Angiography Demonstrates a High Burden of Coronary Artery Disease Despite Low‐Risk Nuclear Studies in Pre–Liver Transplant Evaluation

Contact Info

Product

Resources

About