Document Detail


Diagnostic and prognostic value of myocardial perfusion gated SPECT in orthotopic heart transplant recipients.
MedLine Citation:
PMID:  20151240     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac allograft vasculopathy (CAV) limits long-term survival after heart transplantation. Diagnostic and prognostic value of gated single photon emission computed tomography (gated SPECT) has not been documented in this setting. METHODS AND RESULTS: We identified 110 consecutive heart transplant recipients (with transplantation >18 months) who underwent stress-rest gated SPECT and coronary angiography within 1 month, and were clinically monitored in a single heart transplantation center. Visual scoring of perfusion and wall motion images used a 16-segment model. Left ventricular function was automatically calculated. Coronary angiography was normal in 64 patients (58%) and abnormal in 46 (any CAV, 42%), of whom 19 had severe stenoses. Sensitivity and negative predictive (NPV) value were .63 and .75 for identification of any CAV, and .84 and .96 for severe CAV. Cox regression analysis showed that independent predictors of cardiac death and retransplantation were the presence of any angiographic CAV lesions (RR = 8.816, P = .043) and a stress perfusion defect >3 segments (RR = 5.607, P = .0053). A stress perfusion defect >3 segments predicted the need for late coronary revascularization >2 months (RR = 6.11, P = .0002). CONCLUSIONS: We conclude that perfusion gated SPECT is a useful noninvasive screening test and may be proposed to help identify heart transplant recipients with a high risk of poor clinical outcome. A normal gated SPECT was associated with a low risk of cardiac hard event and might alleviate the need for coronary angiography.
Authors:
Alain Manrique; Mathieu Bernard; Anne Hitzel; Michael Bubenheim; Christophe Tron; Denis Agostini; Alain Cribier; Pierre Véra; Jean Paul Bessou; Michel Redonnet
Publication Detail:
Type:  Journal Article     Date:  2010-02-12
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  17     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-206     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Rouen University Hospital, Henri Becquerel Center, Rouen, France. manrique@cyceron.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Angiography / methods
Female
Heart / physiopathology,  radionuclide imaging*
Heart Transplantation / methods*
Humans
Male
Middle Aged
Myocardium / pathology*
Perfusion
Predictive Value of Tests
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon / methods*
Treatment Outcome
Ventricular Function, Left
Comments/Corrections
Comment In:
J Nucl Cardiol. 2010 Apr;17(2):172-4   [PMID:  20165992 ]

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