title: Detection of significant coronary artery stenosis with cardiac dual-source computed tomography angiography in heart transplant recipients.
abstract: Present study evaluates clinical feasibility of cardiac dual-source computed tomography angiography (DSCTA) to detect significant coronary stenosis because of chronic allograft vasculopathy (CAV) after heart transplantation (HTX). An overall of 51 consecutive heart transplant recipients (43 men, 8 women, mean age: 52.3 ± 13.6 years) underwent DSCTA 1 ± 2 days before annual routine invasive coronary angiography (ICA). Three patients were excluded from further analysis. Total 714/717 (99.6%) segments in remaining 48 patients were depicted in diagnostic image quality by DSCTA with three vessel segments in two patients being additionally excluded because of motion artefacts. On a segment-based analysis, sensitivity, specificity, and diagnostic accuracy (DA) for detection of significant stenosis were calculated as 100%, 98.9% and 98.9% respectively. On a patient-based evaluation, sensitivity, specificity and DA were 100%, 86.0% and 93.0% respectively for remaining 46 patients. Negative predictive value (NPV) was 100%. DSCTA enables diagnosis and especially the exclusion of significant coronary artery stenosis in patients after HTX with a high NPV. The low rate of excluded vessel segments compared with former studies indicates improvement in image acquisition and robustness of latest scanner technology and thus may make subsequent annual invasive coronary angiography unnecessary.
authors: Department of Cardiology, University of Munich, Campus Grosshadern, Munich, Germany. franz.ziegler@med.uni-muenchen.de
authors: Franz
authors: F
authors: von Ziegler
authors: Janine
authors: J
authors: Rümmler
authors: Ingo
authors: I
authors: Kaczmarek
authors: Martin
authors: M
authors: Greif
authors: Jan
authors: J
authors: Schenzle
authors: Susanne
authors: S
authors: Helbig
authors: Christoph
authors: C
authors: Becker
authors: Bruno
authors: B
authors: Meiser
authors: Alexander
authors: A
authors: Becker
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*