Value of Stress Myocardial Perfusion Scanning in Diagnosis of Severe Coronary Artery Disease in Liver Transplantation Candidates

Accuracy of Stress Myocardial Perfusion Imaging to Diagnose Coronary Artery Disease in End Stage Liver Disease Patients

“…Davidson et al 10 reported sensitivity of 37% and specificity of 63% for a group of 83 patients. Aydinalp et al 11 reported an unusually high sensitivity of 100% with specificity of 61% and negative predictive value of 100% in 93 candidates for liver transplantation. Our study population is 4 times as large as these other studies, and our findings are consistent with the report of poor sensitivity of these pharmacologic radionuclide imaging studies.…”

Liver Transplantation Outcome in Patients With Angiographically Proven Coronary Artery Disease: A Multi-Institutional Study

“…We categorized the groups with no CAD and mild CAD together based on a report of similar long term mortality (20). We chose patients without angiographic evidence of CAD as the comparator group to avoid the inclusion of patients who were evaluated exclusively with noninvasive CAD testing due to concerns over the lack of reliability of noninvasive CAD screening methods in the LT candidate population (5,(11)(12)(13)(14)(15).…”

“…Despite the increased prevalence of CAD in LT candidates, there are few studies that have characterized the effect of CAD severity and treatment on the outcome of LT patients (4)(5)(6)(7). Due to the aging of patients with end-stage liver disease (ESLD), an increasing number of older patients on LT waitlists, and limited organ resources, coronary angiography is increasingly advocated to evaluate LT candidates (8)(9)(10) Angiography is often employed in place of noninvasive testing in the evaluation of older and higher risk candidates, as noninvasive tests for myocardial ischemia have varying degrees of reliability in LT candidates (5,(11)(12)(13)(14)(15). To date, no multicenter study has investigated the post-LT survival of patients with angiographically proven obstructive CAD.…”

Cardiac imaging for the assessment of patients being evaluated for kidney or liver transplantation

“…Abnormal MPI was defined as reversible perfusion defects and CAD was angiographically defined as C70% stenosis in one or more coronary segments or C50% stenosis corresponding with an abnormal MPI. 66 The prevalence of CAD was only 6.5%. The sensitivity and specificity of SPECT-MPI were 100% and 61%, respectively, with PPV and NPV of 15% and 100%, respectively (Table 3).…”