Cardiac allograft vasculopathy other imaging findings
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Cardiac allograft vasculopathy Microchapters |
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Differentiating Cardiac allograft vasculopathy from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]; Raviteja Guddeti, M.B.B.S. [3]
Overview
Non-invasive testing by stress electrocardiography is of limited use in the diagnosis of cardiac allograft vasculopathy (CAV) due to high frequency of baseline electrocardiographic abnormalities and the reduced exercise tolerance in heart transplant recipients. Therefore adjunctive imaging in the form of stress echocardiogram and radionuclide imaging to improve sensitivity and specificity has been used for this purpose.
Other Imaging Findings
Dobutamine Stress Echocardiogram
Akosah et al first reported the use of dobutamine stress echocardiogram (DSE) in the diagnosis of CAV.[1] The study demonstrated the sensitivity, specificity, negative predictive value and positive predictive value of DSE to be 95%, 55%, 69% and 92% respectively. Subsequently several studies compared the efficacy of DSE in combination with coronary angiography and with or without intravascular ultrasound for detecting the presence and severity of CAV.[2][3][4]
References
- ↑ Akosah KO, Mohanty PK, Funai JT, Jesse RL, Minisi AJ, Crandall CW; et al. (1994). "Noninvasive detection of transplant coronary artery disease by dobutamine stress echocardiography". J Heart Lung Transplant. 13 (6): 1024–38. PMID 7865509.
- ↑ Derumeaux G, Redonnet M, Soyer R, Cribier A, Letac B (1998). "Assessment of the progression of cardiac allograft vasculopathy by dobutamine stress echocardiography". J Heart Lung Transplant. 17 (3): 259–67. PMID 9563602.
- ↑ Akosah KO, McDaniel S, Hanrahan JS, Mohanty PK (1998). "Dobutamine stress echocardiography early after heart transplantation predicts development of allograft coronary artery disease and outcome". J Am Coll Cardiol. 31 (7): 1607–14. PMID 9626841.
- ↑ Spes CH, Klauss V, Mudra H, Schnaack SD, Tammen AR, Rieber J; et al. (1999). "Diagnostic and prognostic value of serial dobutamine stress echocardiography for noninvasive assessment of cardiac allograft vasculopathy: a comparison with coronary angiography and intravascular ultrasound". Circulation. 100 (5): 509–15. PMID 10430765.