title: Coronary artery disease after heart transplantation: non-invasive evaluation with exercise thallium scintigraphy.
abstract: In order to assess the value of exercise thallium scintigraphy for the detection and prognosis of graft coronary artery disease, 50 heart transplant patients (mean age 46.7 +/- 11.5 years) were studied within 48 h of their scheduled yearly coronary angiography and subsequently followed up for a mean of 13 +/- 3 months. Angiography revealed normal coronary arteries in 35 patients, and coronary artery disease in 15 (two with type A lesions, seven with type B lesions and six with both). Seven patients had one or more stenoses > or = 50%. Exercise thallium scintigraphy was negative in all patients with normal coronary arteries (100% specificity), and abnormal in 10 of 15 patients with coronary artery disease (67% sensitivity). Fixed defects were seen in six cases, transient defects in two and both in two; the results of the test were abnormal in all seven patients with > or = 50% lesions. During follow-up, none of the patients with a normal exercise thallium scintigraphy experienced any cardiac event; in the group with abnormal results, four cardiac events occurred. Although further studies are needed to confirm these results, exercise thallium scintigraphy seems to be useful in evaluating post-transplant coronary artery disease: it is accurate in detecting the most severe stenoses and provides some prognostic information.
authors.affiliation: Department of Cardiology A. De Gasperis, Ospedale Ca Granda, Milan, Italy.
authors.forename: G R
authors.initials: GR
authors.lastname: Ciliberto
authors.forename: M
authors.initials: M
authors.lastname: Mangiavacchi
authors.forename: F
authors.initials: F
authors.lastname: Banfi
authors.forename: D
authors.initials: D
authors.lastname: Massa
authors.forename: G
authors.initials: G
authors.lastname: Danzi
authors.forename: G
authors.initials: G
authors.lastname: Cataldo
authors.forename: M
authors.initials: M
authors.lastname: Cipriani
authors.forename: G
authors.initials: G
authors.lastname: Piccalò
authors.forename: A
authors.initials: A
authors.lastname: Dabalà
authors.forename: E
authors.initials: E
authors.lastname: Gronda
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes