Heart failure & cardiomyopathies

CT Coronary Angiography and Dynamic CT Myocardial Perfusion for Detection of Cardiac Allograft Vasculopathy

JACC Cardiovasc ImagingPublished Diagnostic accuracy study

Authors' conclusion

The combination of CT-MPI and CCTA demonstrated excellent diagnostic performance for the detection of CAV.

Study context

Population
Heart transplantation patients (median 4.3 years after transplantation)35 (55.6%) with cardiac allograft vasculopathy (CAV)
Participants
63 patients
Comparison
Computed tomography-myocardial perfusion imaging (CT-MPI) and coronary computed tomography angiography (CCTA) vs invasive coronary angiography (ICA) with intravascular ultrasonography (IVUS) for CAV
Outcome
Diagnostic performance of dynamic CT-MPI and CCTA for CAV

Performance

As reported in the abstract

Detection of CAV
Test or modelAUCSensitivitySpecificityPPVNPV
CCTA stenosis + MBFmin0.88674.3%96.4%96.3%75.0%

CCTA stenosis + MBFmin

AUC0.886
Sensitivity74.3%
Specificity96.4%
PPV96.3%
NPV75.0%

Further findings

MBFglobal, CAV vs no CAV

P = 0.014

MBFmin, CAV vs no CAV

P < 0.001

Original publication

CT Coronary Angiography and Dynamic CT Myocardial Perfusion for Detection of Cardiac Allograft Vasculopathy. JACC Cardiovasc Imaging. Published 12 April 2023. doi:10.1016/j.jcmg.2022.12.031

Summarised from the published abstract; every number is checked against it

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