title: Qualitative Perfusion Cardiac Magnetic Resonance Imaging Lacks Sensitivity in Detecting Cardiac Allograft Vasculopathy.
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) is a major complication after heart transplantation, requiring frequent surveillance angiography. Though cardiac angiography is the gold standard, it is insensitive in detecting transplant vasculopathy and invasive. Perfusion MRI provides a noninvasive alternative and possibly a useful modality for studying CAV. We sought to compare the accuracy of qualitative perfusion MRI to coronary angiography in detecting CAV.
  
  
  METHODS
  A retrospective analysis was performed in 68 heart transplant recipients who had simultaneous surveillance cardiac MRI and coronary angiogram and who underwent transplantation between 2000 and 2007. We compared results of qualitative MRI to those of the cardiac angiogram. Sensitivity and specificity of MR were calculated.
  
  
  RESULTS
  Sixty-eight patients underwent both cardiac MRI and coronary angiogram. 73.5% were male; mean age was 45.37 ± 14 years. Mean duration of heart transplantation was 7.9 ± 5.2 years. The mean ejection fraction was 55% in the patients without CAV and 57.4% in those with CAV. There were 48 normal and 24 abnormal MRI studies. The overall sensitivity was 41% and specificity was 74%.
  
  
  CONCLUSIONS
  Qualitative assessment of perfusion cardiac MR has low sensitivity and moderate specificity for detecting CAV. The sensitivity of MRI was slightly improved with severity of disease.
authors.affiliation: University of Minnesota, Cardiovascular Division, Minneapolis, MN 55455, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Colvin-Adams
authors.affiliation: University of Minnesota, Cardiovascular Division, Minneapolis, MN 55455, USA.
authors.forename: Salam
authors.initials: S
authors.lastname: Petros
authors.affiliation: University of Minnesota, Cardiovascular Division, Minneapolis, MN 55455, USA.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Raveendran
authors.affiliation: University of Minnesota, Cardiovascular Division, Minneapolis, MN 55455, USA.
authors.forename: Emil
authors.initials: E
authors.lastname: Missov
authors.affiliation: University of Minnesota, Cardiovascular Division, Minneapolis, MN 55455, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Medina
authors.affiliation: University of Minnesota, Cardiovascular Division, Minneapolis, MN 55455, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Wilson
keywords: Cardiac allograft vasculopathy; Cardiac transplantation; MRI