Dual-source CT coronary angiogram in heart transplant recipients in comparison with dobutamine stress echocardiography for detection of cardiac allograft vasculopathy.
Conventional coronary angiography (CCA) is the gold standard in the diagnosis of cardiac allograft vasculopathy (CAV) in heart transplant recipients. Dobutamine stress echocardiography (DSE) is a useful technique for screening. Dual-source computed tomography (DSCT) is the last generation of computed tomography scanners, which could be useful to noninvasively assess CAV. Thirty cardiac transplant recipients underwent DSE and DSCT coronary angiogram. Exclusion criteria were as follows: renal insufficiency, iodinated contrast media allergy, less than 12 months since transplant, and unstable clinical conditions. DSE showed ischemia in two patients. At DSCT scan 13 patients had a normal angiogram, 13 ones wall thickening and four significant diseases. DSCT showed a sensitivity of 100% with a specificity of 92%. DSCT allowed detection of more patients with CAV than DSE. Four patients showed significant CAV at DSCT compared with two at DSE. Thirteen patients showed initial signs of disease at DSCT despite a normal DSE.
Mastrobuoni
Stefano
S
Department of Cardiovascular Surgery, Clínica Universitaria de Navarra, Universidad de Navarra, avenida Pio XII 36, 31008, Pamplona, Spain. smastrobuoni@unav.es
Bastarrika
Gorka
G
Ubilla
Matias
M
Castaño
Sara
S
Azcarate
Pedro
P
Barrero
Eduardo Alegria
EA
Castellano
Jose Maria
JM
Herreros
Jesus
J
Rabago
Gregorio
G
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D004280:Dobutamine / Q000627:therapeutic use; D004452:Echocardiography; D005080:Exercise Test; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous
D004280:Dobutamine