Key result
Dual-source CT showed 100% sensitivity and 92% specificity for detecting cardiac allograft vasculopathy, identifying more patients with significant disease (4 vs 2) than dobutamine stress echo.
Why the study?
Does dual-source computed tomography (DSCT) improve the detection of cardiac allograft vasculopathy compared to dobutamine stress echocardiography in heart transplant recipients?
Cross-Sectional (n=30)
Does dual-source computed tomography (DSCT) improve the detection of cardiac allograft vasculopathy compared to dobutamine stress echocardiography in heart transplant recipients?
DSCT coronary angiography is more sensitive than dobutamine stress echocardiography for detecting early and significant cardiac allograft vasculopathy in heart transplant recipients.
DSCT may improve CAV detection versus stress echo in transplant recipients; hypothesis-generating and should not yet change surveillance practice.
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.
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Mastrobuoni et al. (2009) conducted a cross-sectional in Cardiac allograft vasculopathy in heart transplant recipients (n=30). Dual-source computed tomography (DSCT) coronary angiogram vs. Dobutamine stress echocardiography (DSE) was evaluated on Detection of cardiac allograft vasculopathy (Sensitivity 100%, Specificity 92%). Dual-source CT showed 100% sensitivity and 92% specificity for detecting cardiac allograft vasculopathy, identifying more patients with significant disease (4 vs 2) than dobutamine stress echo.
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