Electron-beam computed tomography in the assessment of coronary artery disease after heart transplantation.

Abstract:

BACKGROUND:Our aim was to compare the electron-beam CT (EBCT) features of coronary arteries in heart transplant recipients with those of biplane coronary angiography and intracoronary ultrasound (ICUS). METHODS AND RESULTS:We examined 112 heart transplant recipients (25 female; age, 17 to 69 years; median, 52 years) 1 to 153 months (median, 46 months) after surgery by EBCT to detect coronary artery calcifications. Calcifications were quantified by the Agatston scoring system. EBCT scores were compared with coronary angiography in all patients and ICUS of the left anterior descending coronary artery (LAD) in 100 patients. Coronary artery calcifications were found in 84 patients (75%). Angiographically, 16 patients displayed >50% coronary artery stenoses, all of whom had some degree of coronary artery calcification and only 1 of whom had a score of <55 (P<0.0001). With this threshold, EBCT had a sensitivity of 94%, a specificity of 79%, a positive predictive value of 43%, and a negative predictive value of 99% for detecting stenosis. ICUS confirmed the presence of calcified plaques in all patients with an LAD score >9. EBCT total calcium score was associated with the degree of intimal proliferation in that patients without ICUS features of allograft vasculopathy had a median score of 0 (25th percentile, 0; 75th percentile, 0), whereas patients with Stanford class IV vasculopathy had a median score of 41 (9 to 98, P<0.0001). CONCLUSIONS:EBCT is a promising noninvasive test for the detection of coronary heart disease in cardiac transplant recipients.

journal_name

Circulation

journal_title

Circulation

authors

Knollmann FD,Bocksch W,Spiegelsberger S,Hetzer R,Felix R,Hummel M

doi

10.1161/01.cir.101.17.2078

subject

Has Abstract

pub_date

2000-05-02 00:00:00

pages

2078-82

issue

17

eissn

0009-7322

issn

1524-4539

journal_volume

101

pub_type

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