https://scholars.lib.ntu.edu.tw/handle/123456789/471111
Title: | Usefulness of progressive inhomogeneity of myocardial perfusion and chronotropic incompetence in detecting cardiac allograft vasculopathy: Evaluation with dobutamine thallium-201 myocardial SPECT | Authors: | YEN-WEN WU RUOH-FANG YEN CHII-MING LEE YI-LWUN HO SHOEI-SHEN WANG RON-BIN HSU NAI-KUAN CHOU Huang P.-J. |
Issue Date: | 2005 | Journal Volume: | 104 | Journal Issue: | 3 | Start page/Pages: | 156-161 | Source: | Cardiology | Abstract: | Background: The aim of the study was to investigate the value of longitudinal follow-up of dobutamine thallium-201 single photon emission tomography (201TI SPECT) in the development of significant cardiac allograft vasculopathy (CAV) after orthotopic heart transplantation. Methods: We studied 38 cardiac recipients (mean age 57 ± 12 years) who underwent at least two follow-up dobutamine 201TI SPECT since January 1998. All patients had normal coronary angiography and normal left ventricular function initially. Results: After 2.3 ± 1.8 years, 12 patients developed significant CAV and there were 4 cardiac deaths (1 died suddenly). Of the 99 scans retrospectively analyzed, patients with significant CAV had elevated values of inhomogeneity score, lung/heart ratio (LHR) at stress and lower left ventricular ejection fraction (all p < 0.05). The higher values of inhomogeneity were significantly correlated with higher stress LHR (r = 0.301, p = 0.021), and lower ejection fraction (r = -0.379, p < 0.001). Progressive inhomogeneity was noted in all heart recipients, and more rapid, although statistically insignificant, in patients who developed significant CAV. Ten patients had inadequate chronotropic response to dobutamine infusion up to 40 μg/kg/min in the follow-up studies. The late onset of chronotropic incompetence was an independent predictor of CAV development (p = 0.03). Conclusions: Progressive inhomogeneity of myocardial perfusion, higher lung uptake at stress and chronotropic incompetence assessed by dobutamine 201TI myocardial SPECT provide incremental diagnostic value in detecting significant CAV. Copyright ? 2005 S. Karger AG. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-24744452344&doi=10.1159%2f000087767&partnerID=40&md5=5e82a5ab03055d96d5b9992ec1477085 https://scholars.lib.ntu.edu.tw/handle/123456789/471111 |
ISSN: | 0008-6312 | DOI: | 10.1159/000087767 | SDG/Keyword: | dobutamine tl 201; radiopharmaceutical agent; unclassified drug; adult; aged; angiocardiography; article; cardiac allograft vasculopathy; chronotropism; clinical article; correlation analysis; diagnostic value; female; follow up; heart death; heart left ventricle ejection fraction; heart left ventricle function; heart muscle perfusion; heart transplantation; human; male; orthotopic transplantation; postoperative complication; priority journal; retrospective study; single photon emission computer tomography; time series analysis; Adrenergic beta-Agonists; Aged; Dobutamine; Female; Follow-Up Studies; Heart Diseases; Heart Rate; Heart Transplantation; Humans; Male; Middle Aged; Myocardial Reperfusion; Postoperative Complications; Predictive Value of Tests; Radiopharmaceuticals; Retrospective Studies; Sensitivity and Specificity; Stroke Volume; Survival Analysis; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Transplantation, Homologous; Treatment Outcome |
Appears in Collections: | 醫學系 |
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