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Prediction of long-term (> 10 year) cardiovascular outcomes in heart transplant recipients: Value of stress technetium-99m tetrofosmin myocardial perfusion imaging.
- Source :
-
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2019 Jun; Vol. 26 (3), pp. 845-852. Date of Electronic Publication: 2017 Nov 07. - Publication Year :
- 2019
-
Abstract
- Background: Myocardial perfusion imaging (MPI) using single-photon emission computed tomography (SPECT) is useful in the evaluation of cardiac allograft vasculopathy (CAV) in heart transplant (HTx) recipients. The current study evaluated the long-term prognostic value of stress SPECT MPI for predicting all-cause mortality and cardiac events in HTx recipients.<br />Methods: The study population consisted of 166 HTx recipients (mean age 54 ± 10 years, 84% male) who underwent exercise or dobutamine stress <superscript>99m</superscript> Tc-tetrofosmin SPECT MPI for the assessment of CAV. An abnormal SPECT MPI was defined as the presence of a fixed or a reversible perfusion defect. Endpoints were all-cause mortality, cardiac mortality, and non-fatal myocardial infarction (MI).<br />Results: MPI abnormalities were detected in 55 patients (33%), including fixed defects in 28 patients (17%), partially reversible in 17 patients (10%), and completely reversible defects in 10 patients (6%). During a median follow-up of 12.8 years (range 0-15, mean follow-up 9.5 years), 109 (66%) patients died (all-cause mortality), of which 67 (40%) were due to cardiac causes. A total of 5 (3%) patients experienced a non-fatal MI. HTx recipients with a normal stress <superscript>99m</superscript> Tc-tetrofosmin SPECT MPI had a significantly better prognosis as compared with those with an abnormal study, up to 5 years after the initial test. The presence of a reversible perfusion defect was a significant predictor of all-cause mortality, cardiac mortality, and major cardiac events, during the entire follow-up period.<br />Conclusions: Stress <superscript>99m</superscript> Tc-tetrofosmin SPECT MPI provides valuable prognostic information for the prediction of long-term outcome in HTx recipients. Patients with a normal stress <superscript>99m</superscript> Tc-tetrofosmin SPECT MPI have a significantly better prognosis as compared with those with an abnormal study, up to 5 years after initial testing.
- Subjects :
- Adult
Exercise Test
Female
Heart Diseases etiology
Humans
Male
Middle Aged
Predictive Value of Tests
Time Factors
Treatment Outcome
Heart Diseases diagnostic imaging
Heart Transplantation
Myocardial Perfusion Imaging
Organophosphorus Compounds
Organotechnetium Compounds
Radiopharmaceuticals
Tomography, Emission-Computed, Single-Photon
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6551
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 29116562
- Full Text :
- https://doi.org/10.1007/s12350-017-1089-3