[Importance of dual isotope myocardial tomoscintigraphy in the detection of coronary disease in the graft among 96 heart transplant recipients].

Abstract

With a survival rate of 70% at 3 years, cardiac transplantation is the best treatment for end-stage heart disease. However, progressive development of graft atherosclerosis is frequent. Diagnosis of transplant coronary disease remains difficult and non-invasive tests have proved relatively insensitive. Therefore, coronary angiography performed annually is still the gold-standard test for the detection of heart transplant vasculopathy. We analyzed the records of 96 patients (82 men and 14 women) who were transplanted from 1986 to 1996. Mean age was 53 +/- 2.7 and time elapsed from transplantation was mean 5.3 +/- 10 years. All patients had rest myocardial TI 201 perfusion SPECT, followed by MIBI gated SPECT after exercise. MIBI gated SPECT allows simultaneous evaluation of perfusion, regional LV function and global ejection fraction. Angiocoronarography, performed in all patients during the six months following radionuclide investigation, showed the presence of coronary heart vasculopathy in nine (9.3%). Seven of these patients had abnormal dual isotope imaging and 2 of them had normal perfusion but altered LV regional function. Sensitivity of dual isotope scintigraphy was 77% and specificity was 97.7%. Dual isotope scintigraphy is helpful to detect coronary vasculopathy in heart transplant recipients and may reduce indications of angiocoronarography.

• Authors: F Pouillart, M Levy, C Amrein, R Guillemain, T Perez, S Makowski, P Chevallier, A Fabiani, A Carpentier
• Journal: Archives des maladies du coeur et des vaisseaux (Arch Mal Coeur Vaiss) Vol. 92 Issue 2 Pg. 235-41 (Feb 1999) ISSN: 0003-9683 [Print] France
• Vernacular Title: Intérêt de la tomoscintigraphie myocardique double isotope dans la détection de la maladie coronaire du greffon chez 96 transplantés cardiaques.
• PMID: 10078343 (Publication Type: Journal Article)

Chemical References

• Thallium Radioisotopes
• Dipyridamole
• Technetium Tc 99m Sestamibi

Topics

• Coronary Angiography
• Coronary Artery Disease (diagnostic imaging)
• Coronary Circulation
• Coronary Vessels (diagnostic imaging)
• Dipyridamole
• Exercise Test
• Female
• Heart (diagnostic imaging)
• Heart Transplantation (diagnostic imaging)
• Humans
• Male
• Middle Aged
• Postoperative Complications (diagnostic imaging)
• Prognosis
• Retrospective Studies
• Sensitivity and Specificity
• Technetium Tc 99m Sestamibi
• Thallium Radioisotopes
• Tomography, Emission-Computed, Single-Photon
• Ventricular Function, Left