title: Imaging in patients after cardiac transplantation and in patients with ventricular assist devices.
abstract: The field of cardiac imaging and the management of patients with severe heart failure have advanced substantially during the past 10 years. Cardiac transplantation offers the best long-term survival with high quality of life for the patients with end stage heart failure. However, acute cardiac rejection and cardiac allograft vasculopathy (CAV) can occur post cardiac transplantation and these problems necessitate regular surveillance. The short-term success of mechanical circulatory support devices (MCSD), such as ventricular assist devices (VADs), in improving survival and quality of life has led to a dramatic growth of the patient population with these devices. The development of optimal imaging techniques and algorithms to evaluate these advanced heart failure patients is evolving and multimodality non-invasive imaging approaches and invasive techniques are commonly employed. Most of the published studies done in the transplant and VAD population are small, and biased based on the strength of the particular program, and there is a relative lack of published protocols to evaluate these patient groups. Moreover, the techniques of echocardiography, computed tomography (CT), magnetic resonance imaging, and nuclear cardiology have all progressed rapidly in recent years. There is thus a knowledge gap for cardiologists, radiologists, and clinicians, especially regarding surveillance for CAV and ideal imaging approaches for patients with VADs. The purpose of this review article is to provide an overview of different noninvasive imaging modalities used to evaluate patients after cardiac transplantation and for patients with VADs. The review focuses on the role of echocardiography, CT, and nuclear imaging in surveillance for CAV and rejection and on the assessment of ventricular structure and function, myocardial remodeling and complications for VAD patients.
authors.affiliation: Department of Cardiology, St. Luke's Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO, USA.
authors.forename: Bhanu
authors.initials: B
authors.lastname: Gupta
authors.forename: Dany
authors.initials: D
authors.lastname: Jacob
authors.forename: Randall
authors.initials: R
authors.lastname: Thompson
mesh_terms: D004452:Echocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000628:therapy*; D016027:Heart Transplantation / Q000379:methods*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011379:Prognosis; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
references.citation: J Heart Lung Transplant. 2000 Sep;19(9):873-8
references.pmid: 11008077
references.citation: Eur J Echocardiogr. 2003 Mar;4(1):29-35
references.pmid: 12565060
references.citation: J Nucl Med. 2010 Jul;51(7):1044-8
references.pmid: 20554736
references.citation: Cardiol Res Pract. 2011 Feb 08;2011:187434
references.pmid: 21331332
references.citation: Am J Transplant. 2010 Jul;10 (7):1668-76
references.pmid: 20642688
references.citation: Transplant Proc. 2001 Nov-Dec;33(7-8):3539-42
references.pmid: 11750507
references.citation: JACC Cardiovasc Imaging. 2010 Jan;3(1):64-70
references.pmid: 20129533
references.citation: J Heart Lung Transplant. 2005 Nov;24(11):1710-20
references.pmid: 16297770
references.citation: JACC Cardiovasc Imaging. 2010 Oct;3(10 ):1049-64
references.pmid: 20947051
references.citation: J Heart Lung Transplant. 2006 Feb;25(2):153-9
references.pmid: 16446213
references.citation: J Heart Lung Transplant. 2014 Apr;33(4):372-81
references.pmid: 24582837
references.citation: J Am Coll Cardiol. 2014 May 20;63(19):1992-2004
references.pmid: 24681148
references.citation: N Engl J Med. 2014 Jan 2;370(1):33-40
references.pmid: 24283197
references.citation: J Heart Lung Transplant. 2005 May;24(5):544-50
references.pmid: 15896751
references.citation: J Am Soc Echocardiogr. 2009 Sep;22(9):1055-62
references.pmid: 19647406
references.citation: J Heart Lung Transplant. 2009 Mar;28(3):213-25
references.pmid: 19285611
references.citation: J Nucl Med. 2008 Feb;49(2):234-41
references.pmid: 18199620
references.citation: Circulation. 2006 Jul 4;114(1 Suppl):I49-55
references.pmid: 16820624
references.citation: ASAIO J. 2011 Jan-Feb;57(1):32-7
references.pmid: 20966744
references.citation: Transplantation. 2009 Feb 27;87(4):587-90
references.pmid: 19307798
references.citation: J Heart Lung Transplant. 2002 Apr;21(4):446-54
references.pmid: 11927221
references.citation: Am J Cardiol. 2004 Jul 15;94(2):202-6
references.pmid: 15246902
references.citation: J Am Coll Cardiol. 2005 Jun 7;45(11):1826-31
references.pmid: 15936614
references.citation: Am J Cardiol. 2006 Oct 1;98(7):877-84
references.pmid: 16996866
references.citation: J Thorac Cardiovasc Surg. 2009 May;137(5):1213-7
references.pmid: 19379994
references.citation: J Heart Lung Transplant. 2012 Jul;31(7):719-28
references.pmid: 22425234
references.citation: J Am Soc Echocardiogr. 2010 Jul;23 (7):685-713; quiz 786-8
references.pmid: 20620859
references.citation: Heart Fail Clin. 2007 Jan;3(1):11-5
references.pmid: 17545005
references.citation: J Heart Lung Transplant. 2004 Dec;23(12):1359-65
references.pmid: 15607664
references.citation: Circulation. 2003 Sep 30;108(13):1605-10
references.pmid: 12963639
references.citation: J Am Coll Cardiol. 2009 Apr 14;53(15):1279-86
references.pmid: 19358941
references.citation: J Heart Lung Transplant. 2010 Feb;29(2):195-200
references.pmid: 19782604
references.citation: Circulation. 2010 Aug 31;122(9):900-9
references.pmid: 20713901
references.citation: J Heart Lung Transplant. 2010 May;29(5):554-61
references.pmid: 20044278
references.citation: J Heart Lung Transplant. 2003 Mar;22(3):292-300
references.pmid: 12633697
references.citation: ASAIO J. 2004 Sep-Oct;50(5):432-7
references.pmid: 15497381
references.citation: Ann Thorac Surg. 2005 Apr;79(4):1344-51
references.pmid: 15797075
references.citation: J Heart Lung Transplant. 2014 Jan;33(1):12-22
references.pmid: 24418730
references.citation: J Heart Transplant. 1989 Nov-Dec;8(6):430-43
references.pmid: 2693662
references.citation: JACC Cardiovasc Imaging. 2013 Jul;6(7):772-84
references.pmid: 23845574
references.citation: J Cardiothorac Surg. 2009 Aug 16;4:43
references.pmid: 19682394
references.citation: Transplantation. 2008 Jun 15;85(11):1580-7
references.pmid: 18551063
references.citation: J Am Coll Cardiol. 2003 Mar 19;41(6):1021-7
references.pmid: 12651052
references.citation: Transpl Int. 2012 Oct;25(10 ):1065-71
references.pmid: 22816613
references.citation: J Am Coll Cardiol. 2010 Jul 27;56(5):382-91
references.pmid: 20650360
references.citation: Eur J Nucl Med. 2000 Jan;27(1):1-6
references.pmid: 10654140
references.citation: Cardiovasc Ultrasound. 2012 Nov 14;10 :44
references.pmid: 23150924
references.citation: JACC Cardiovasc Imaging. 2014 Aug;7(8):839-42
references.pmid: 25124016
references.citation: J Heart Lung Transplant. 2003 Nov;22(11):1276-9
references.pmid: 14585389
references.citation: Clin Nucl Med. 2005 Jan;30(1):16-7
references.pmid: 15604960
references.citation: Eur Heart J Cardiovasc Imaging. 2014 Oct;15(10):1125-32
references.pmid: 24908664
references.citation: J Am Coll Cardiol. 2009 Feb 3;53(5):426-35
references.pmid: 19179201
references.citation: J Nucl Cardiol. 2011 Aug;18(4):628-33
references.pmid: 21626090
references.citation: Am J Cardiol. 1974 Jan;33(1):87-94
references.pmid: 4808557
references.citation: Rofo. 2003 Jan;175(1):83-8
references.pmid: 12525986
references.citation: J Heart Lung Transplant. 2010 Oct;29(10):1089-103
references.pmid: 20870164
references.citation: J Heart Lung Transplant. 2015 Feb;34(2):195-203
references.pmid: 25108908
references.citation: J Am Coll Cardiol. 2014 Mar 4;63(8):799-808
references.pmid: 24355800
references.citation: Int J Cardiol. 2005 Aug 18;103(2):201-6
references.pmid: 16080981
references.citation: Int J Cardiovasc Imaging. 2013 Aug;29(6):1335-40
references.pmid: 23440348
references.citation: Am J Cardiol. 2009 Nov 15;104(10 ):1351-6
references.pmid: 19892049
references.citation: Am J Transplant. 2006 May;6(5 Pt 1):998-1003
references.pmid: 16611336
references.citation: Circulation. 2008 Apr 22;117(16):2131-41
references.pmid: 18427143
references.citation: J Heart Transplant. 1990 Nov-Dec;9(6):587-93
references.pmid: 2277293
references.citation: Circ J. 2010 May;74(5):946-53
references.pmid: 20215697
references.citation: J Am Soc Echocardiogr. 2000 Aug;13(8):754-63
references.pmid: 10936819
references.citation: J Heart Lung Transplant. 2014 Jan;33(1):1-11
references.pmid: 24418729
references.citation: Circulation. 2000 Apr 25;101(16):1899-906
references.pmid: 10779454
references.citation: Circulation. 2003 Jul 8;108(1):48-53
references.pmid: 12742978
references.citation: J Heart Lung Transplant. 2004 Nov;23(11):1238-44
references.pmid: 15539121
references.citation: Circulation. 1999 Aug 3;100(5):509-15
references.pmid: 10430765
references.citation: Cardiovasc Res. 2008 Nov 1;80(2):165-74
references.pmid: 18511433
references.citation: J Am Coll Cardiol. 2010 May 18;55(20):2212-21
references.pmid: 20188504
references.citation: Eur J Nucl Med Mol Imaging. 2008 Mar;35(3):535-46
references.pmid: 18043919
references.citation: J Heart Lung Transplant. 2011 Apr;30(4):375-84
references.pmid: 21419995
references.citation: J Am Coll Cardiol. 2012 Aug 7;60(6):521-8
references.pmid: 22858287
references.citation: Heart Fail Clin. 2007 Jan;3(1):51-67
references.pmid: 17545009
references.citation: J Am Coll Cardiol. 2006 Aug 15;48(4):772-8
references.pmid: 16904548
references.citation: J Am Coll Cardiol. 2011 Feb 8;57(6):641-52
references.pmid: 21292124
references.citation: J Heart Lung Transplant. 2011 Aug;30(8):896-903
references.pmid: 21530319
references.citation: J Heart Lung Transplant. 2006 Nov;25(11):1363-6
references.pmid: 17097502
references.citation: J Heart Lung Transplant. 2000 Apr;19(4):360-6
references.pmid: 10775817
references.citation: Chest. 2000 Dec;118(6):1792-800
references.pmid: 11115475
references.citation: Ann Thorac Surg. 2003 May;75(5):1624-6
references.pmid: 12735591
references.citation: Tex Heart Inst J. 2005;32(3):263-70
references.pmid: 16392203
references.citation: J Am Coll Cardiol. 1998 Aug;32(2):413-9
references.pmid: 9708469
references.citation: Eur Heart J Cardiovasc Imaging. 2012 Mar;13(3):271-5
references.pmid: 22143401
references.citation: Am J Cardiol. 2017 Nov 1;120(9):1578-1583
references.pmid: 28882335
references.citation: Ann Thorac Surg. 2011 Sep;92(3):929-34
references.pmid: 21871279
references.citation: J Heart Lung Transplant. 2010 Jul;29(7):717-27
references.pmid: 20620917
references.citation: Circulation. 2009 Oct 20;120(16):1561-8
references.pmid: 19805652
references.citation: Am J Cardiol. 2002 Apr 15;89(8):964-8
references.pmid: 11950436
references.citation: J Am Soc Echocardiogr. 2005 Feb;18(2):116-21
references.pmid: 15682047
references.citation: Circ Cardiovasc Imaging. 2015 Jan;8(1):null
references.pmid: 25596140
references.citation: Radiographics. 2007 Sep-Oct;27(5):1297-309
references.pmid: 17848692
references.citation: J Thorac Cardiovasc Surg. 2006 Feb;131(2):447-54
references.pmid: 16434277
references.citation: Transplant Proc. 2003 Sep;35(6):2113-6
references.pmid: 14529859
references.citation: Circulation. 1993 Feb;87(2):454-63
references.pmid: 8381058
references.citation: J Heart Lung Transplant. 2008 Mar;27(3):310-6
references.pmid: 18342754
references.citation: Mayo Clin Proc. 1984 Jan;59(1):17-20
references.pmid: 6694427
references.citation: Eur Heart J. 2001 Jun;22(11):964-71
references.pmid: 11428820
references.citation: J Heart Lung Transplant. 2011 Jun;30(6):601-11
references.pmid: 21555100
references.citation: Int J Cardiovasc Imaging. 2009 Jan;25(1):91-100
references.pmid: 18642098
references.citation: Transplant Proc. 2006 Oct;38(8):2563-5
references.pmid: 17098003
references.citation: Nucl Med Commun. 2005 Jul;26(7):607-12
references.pmid: 15942481
references.citation: Radiology. 2013 May;267(2):609-18
references.pmid: 23297336
references.citation: Kardiol Pol. 2012;70(11):1111-9
references.pmid: 23180518
references.citation: J Am Coll Cardiol. 2012 Mar 20;59(12 ):1058-72
references.pmid: 22421299
references.citation: N Engl J Med. 2011 Jan 20;364(3):226-35
references.pmid: 21247313
references.citation: J Nucl Cardiol. 2010 Apr;17 (2):197-206
references.pmid: 20151240
references.citation: Radiology. 2013 Aug;268(2):374-81
references.pmid: 23657888
references.citation: Eur Radiol. 2011 Sep;21(9):1887-94
references.pmid: 21484350
references.citation: Transplant Proc. 2006 Oct;38(8):2575-6
references.pmid: 17098007
references.citation: J Nucl Cardiol. 2012 Aug;19(4):670-80
references.pmid: 22415819
references.citation: Transplantation. 2007 Aug 27;84(4):498-503
references.pmid: 17713434