Coronary microvascular dysfunction by positron emission tomography and outcomes in patients after cardiac transplantation
Authors' conclusion
In cardiac transplant patients with no history of CAV and normal myocardial perfusion, an endogen/functional pattern of CMD is associated with higher rate of adverse events and death. This association was not present in patients with a classical/structural CMD pattern. Incorporating endogen/microvascular dysfunction assessment in PET/CT reporting may identify a higher-risk group hereto now considered low risk.
Study context
- Population
- Cardiac transplant patients with no prior history of cardiac allograft vasculopathy (CAV) and normal myocardial perfusion imaging, assessed by PET/CTpatients met the inclusion criteria
- Participants
- Three hundred fifty-six patients
- Comparison
- Endogen/functional and classical/structural coronary microvascular dysfunction (CMD) subtypes by PET/CT in cardiac transplant patients without epicardial CAV
- Endogen/functional CMDn = 112 (31.4%)
- Classical/structural CMDn = 29 (8.1%)
- Outcome
- All-cause mortality and a composite of all-cause mortality, heart failure hospitalization, acute coronary syndrome, revascularization, and re-transplantation
Methodological detailsmultivariable adjustment
- Multivariable adjustment
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Endogen/functional CMDcomposite outcome; after multivariable adjustment; higher rate
2.39(1.32–4.29)
P = 0.004Endogen/functional CMDall-cause mortality; after multivariable adjustment
2.98(1.34–6.64)
P = 0.008Classical/structural CMDprimary composite outcome; not associated
0.92(0.27–3.17)
P = 0.893Classical/structural CMDall-cause mortality; not associated
1.22(0.263–5.69)
P = 0.797Further findings
Prevalence of CMD
- CMD present
- 141 (39.6%)
Original publication
Coronary microvascular dysfunction by positron emission tomography and outcomes in patients after cardiac transplantation. Eur Heart J Cardiovasc Imaging. Published 7 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it