Document Detail


Myocardial scintigraphy correlates poorly with coronary angiography in the screening of transplant arteriosclerosis.
MedLine Citation:
PMID:  11521129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary angiography remains an important screening tool for transplant coronary arteriosclerosis (TxCAD) after heart transplantation despite criticism that it underestimates the incidence of TxCAD. In an effort to improve TxCAD incidence estimation, several methods of screening have been proposed. In the present study, the incidence of TxCAD assessed by both yearly coronary angiography and stress myocardial scintigraphy imaging was reviewed. PATIENTS AND METHODS: Ninety-nine consecutive primary heart transplantations were performed from 1988 to 1999. The standard immunosuppression protocol consisted of the introduction of antilymphocyte globulin and steroids, while maintenance therapy was with cyclosporine, imuran and steroids. Coronary angiography and a stress 2-methoxyisobutyl-isonitrile perfusion scan were performed yearly. TxCAD was defined by angiographic evidence of luminal abnormality by catheterization, or a perfusion abnormality at rest or after stress on myocardial scintigraphy. RESULTS: The mean recipient age was 49+/-12 years and the mean donor age was 33+/-13 years. The etiology of heart failure was ischemic cardiomyopathy (50%), dilated cardiomyopathy (41%) and congenital heart disease (9%). The freedom from angiographic TxCAD was 92% at one year, 64% at five years and 35% at eight years. The freedom from nuclear imaging TxCAD was 92% at one year, 69% at five years and 44% at eight years. However, a diagnosis of TxCAD by angiography only correlated with a diagnosis of TxCAD by nuclear imaging 52.8% of the time in the same patient, with a median time between studies of one month. CONCLUSION: The overall incidence of TxCAD diagnosed by angiography and nuclear imaging appears similar but correlates poorly in patients, casting doubt on the routine use of myocardial scintigraphy for screening TxCAD.
Authors:
J F Légaré; H Haddad; D Barnes; J A Sullivan; K J Buth; G Hirsch
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  17     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-24     Completed Date:  2001-09-20     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  866-72     Citation Subset:  IM    
Affiliation:
Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. jflegare@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Coronary Angiography / methods*
Coronary Artery Disease / epidemiology,  radiography*,  radionuclide imaging*
Coronary Vessels / pathology*
Female
Graft Survival
Heart Transplantation / adverse effects*
Humans
Incidence
Male
Mass Screening / methods*
Middle Aged
Prognosis
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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