Evaluation of coronary allograft vasculopathy using multi-detector row computed tomography: a systematic review.
Razi Khan,Ik-Kyung Jang +1 more
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The high sensitivity and NPV of MDCT suggest that it may be a useful, noninvasive screening tool to rule out CAV.Abstract:
Summary Coronary allograft vasculopathy (CAV) is a significant cause of morbidity and mortality after cardiac transplantation and requires frequent surveillance with catheter-based coronary angiography (CCA). Multi-detector row computed tomography (MDCT) has been shown to be effective in assessing atherosclerosis in native coronary arteries. This article systematically reviews the literature to determine the accuracy of MDCT in CAVassessment. An English-language literature search was performed using EMBASE, OVID, PubMed, and Cochrane Library databases. Studies that directly compared MDCTwith CCA and/or IVUS for the detection of coronary artery stenosis or significant intimal thickening in cardiac transplant patients were analyzed. Data were pooled to obtain weighted sensitivities, specificities, and diagnostic accuracies. Negative and positive predictive values (NPV/PPV) were calculated. A total of seven studies with a sum of 272 patients were included in this review. There were three studies examining 16-slice MDCTand four studies looking at 64-slice MDCT in CAV. Using per-segment analysis, MDCTassessed between 91% and 96% of all coronary segments when evaluating for stenosis. Pooled estimates for sensitivity and specificity for MDCTranged from 82% to 89% and 89% to 99%, respectively, while NPV was 99%. Per-patient analysis revealed a sensitivity of 87—100% and NPV of 96—100%. PPV was less than 50% for 64slice MDCT in both per-segment and per-patient analysis. When compared with IVUS, MDCT had a sensitivity of 74—96% and specificity of 88—92% in assessment of intimal thickening. NPVand PPV were 80—81% and 84—98%, respectively. The high sensitivity and NPV of MDCTsuggest that it may be a useful, noninvasive screening tool to rule out CAV. # 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.read more
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Journal ArticleDOI
Coronary computed tomography in heart transplant patients: detection of significant stenosis and cardiac allograft vasculopathy, image quality, and radiation dose.
Anne Günther,Anne Günther,Lars Aaberge,Andreas Abildgaard,Asgrimur Ragnarsson,Thor Edvardsen,Thor Edvardsen,Jarl Å. Jakobsen,Jarl Å. Jakobsen,Rune Andersen +9 more
TL;DR: CCTA with interpretable image quality had a high negative predictive value for ruling out significant stenoses suitable for intervention and the high estimated radiation dose for 64-MDCT is of concern considering the need for repetitive examinations in the HTX population.
Journal ArticleDOI
Dual-source cardiac computed tomography angiography (CCTA) in the follow-up of cardiac transplant: comparison of image quality and radiation dose using three different imaging protocols
Dietrich Beitzke,Vanessa Berger-Kulemann,Veronika Schöpf,Sylvia Unterhumer,Ernest Spitzer,Gudrun Feuchtner,Mariann Gyöngyösi,K. Uyanik-Uenal,Andreas Zuckermann,Christian Loewe,Florian Wolf +10 more
TL;DR: Radiation dose of dual-source CCTA in heart transplant recipients is significantly reduced by using prospective systolic scanning and automated tube voltage selection, while overall IQ and IQ of the large coronary segments are maintained.
Journal ArticleDOI
The role of non-invasive imaging modalities in cardiac allograft vasculopathy: an updated focus on current evidences.
Carlotta Sciaccaluga,Nicolò Ghionzoli,Giulia Elena Mandoli,Nicolò Sisti,Flavio D'Ascenzi,Marta Focardi,S. Bernazzali,Giuseppe Vergaro,Michele Emdin,Serafina Valente,Matteo Cameli +10 more
TL;DR: In this paper, a review of non-invasive and contrast-sparing imaging techniques for cardiac allograft vasculopathy (CAV) detection in transplant patients is presented, including echocardiography, nuclear imaging, cardiac magnetic resonance and cardiac computed tomography angiography.
DissertationDOI
A doença vascular do enxerto diagnosticada pela tomografia computadorizada de múltiplos detectores como preditora de eventos maiores em pacientes submetidos a transplante cardíaco
Journal ArticleDOI
Transplant coronary heart disease: challenges and solutions
TL;DR: There are a variety of invasive, noninvasive, and blood tests that have been studied as screening methods, and the role of each of these is discussed in this review article.
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