Prediction of long-term (> 10 year) cardiovascular outcomes in heart transplant recipients: Value of stress technetium-99m tetrofosmin myocardial perfusion imaging

Journal Article · Sat Jun 15 04:00:00 EDT 2019 · Journal of Nuclear Cardiology (Online)

DOI:https://doi.org/10.1007/S12350-017-1089-3· OSTI ID:22962076

Veenis, Jesse F.; Berge, Jan C. van den ^[1]; Caliskan, Kadir ^[2]; Valkema, Roelf ^[3]; Constantinescu, Alina A.; Manintveld, Olivier C.; Zijlstra, Felix; Domburg, Ron T. van; Schinkel, Arend F. L. ^[2]

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1. Erasmus MC, Department of Cardiology, Thoraxcenter (Netherlands)
2. Erasmus Medical Center, Department of Cardiology (Netherlands)
3. Erasmus Medical Center, Department of Nuclear Medicine (Netherlands)

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. Methods: The study population consisted of 166 HTx recipients (mean age 54 ± 10 years, 84% male) who underwent exercise or dobutamine stress {sup 99m}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). 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 {sup 99m}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. Conclusions: Stress {sup 99m}Tc-tetrofosmin SPECT MPI provides valuable prognostic information for the prediction of long-term outcome in HTx recipients. Patients with a normal stress {sup 99m}Tc-tetrofosmin SPECT MPI have a significantly better prognosis as compared with those with an abnormal study, up to 5 years after initial testing.

• OSTI ID: 22962076
• Journal Information: Journal of Nuclear Cardiology (Online), Journal Name: Journal of Nuclear Cardiology (Online) Journal Issue: 3 Vol. 26; ISSN 1532-6551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
HEART
MORTALITY
MYOCARDIAL INFARCTION
PATIENTS
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
TECHNETIUM 99