Cardiac Positron Emission Tomography (PET) Myocardial Blood Flow Quantification Assessment of Early Cardiac Allograft Vasculopathy
Authors' conclusion
The 1-year post-transplant PET MBF is associated with epicardial CAV, supporting potential use for early noninvasive CAV assessment.
Study context
- Population
- Adult heart transplant recipients at 2 institutions, enrolled January 2018–March 2021136 PET studies analysed
- Participants
- 74 recipients
- Exposure
- PET at 3 months vs 12 months after heart transplant
- Outcome
- CAV assessed by PET myocardial blood flow quantification
- Follow-up
- 1 year
Methodological details2 institutions
- 2 institutions
Main finding
As reported in the abstract
PET MBF measures, 3-month vs 12-month post-transplant · 12 months
- PET myocardial flow reserve increased (2.5 ± 0.7 vs 2.9 ± 0.8)
- P = 0.001
- Stress myocardial blood flow (MBF) increased (2.7 ± 0.6 vs 2.9 ± 0.6)
- P = 0.008
- Coronary vascular resistance unchanged (49 ± 13 vs 47 ± 11)
- P = 0.214
- Correlation of stress MBF with percent intimal volume (PIV) at 12 months
- r = −0.35
- Correlation of coronary vascular resistance (CVR) with PIV at 12 months
- r = 0.33
- Lower stress MBF and higher CVR across increasing PIV tertiles
- all P < 0.05
- AUC of stress MBF for cardiac allograft vasculopathy (CAV) defined by upper-tertile PIV
- 0.74
- AUC of CVR for CAV defined by upper-tertile PIV
- 0.73
Observational data: associations, not effects.
Further findings
Microvascular CAV incidence (endomyocardial biopsy) · 12 months
- Microvascular CAV incidence (endomyocardial biopsy) — No change in microvascular CAV incidence
- P = 0.406
- Microvascular CAV incidence (endomyocardial biopsy) — Persistent microvascular disease
- 13%
Median PIV (epicardial CAV, intravascular ultrasound) · 12 months
- Median PIV increased
- 5.6% (95% CI: 3.6%-7.1%)
Median capillary density · 12 months
- Median capillary density increased
- 30 capillaries/mm² (95% CI: −6 to 79 capillaries/mm²)
Original publication
Cardiac PET Myocardial Blood Flow Quantification Assessment of Early Cardiac Allograft Vasculopathy. JACC Cardiovasc Imaging. Published 22 November 2023. doi:10.
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