Quantitative Cadmium-zinc-telluride (CZT) Single-photon Emission Computed Tomography (SPECT) Myocardial Blood Flow for Physiological Assessment and Risk Stratification of Cardiac Allograft Vasculopathy
Authors' conclusion
Quantitative CZT SPECT-derived MBF and coronary flow capacity provide physiological assessment and risk stratification of CAV, with preliminary associations with CAV-related events. These findings support the prospective multicenter evaluation of CZT SPECT MBF as a widely available, noninvasive orthotopic heart transplantation surveillance strategy.
Study context
- Population
- Orthotopic heart transplantation recipients who underwent coronary angiography and CZT SPECT quantitative myocardial blood flow (MBF) imaging within 12 monthsconsecutive orthotopic heart transplantation recipients
- Participants
- 110 recipients
- Exposure
- Stress MBF, rest MBF, MBF reserve, coronary flow capacity, and total perfusion deficit compared across International Society for Heart and Lung Transplantation cardiac allograft vasculopathy (CAV) categories
Methodological detailsconsecutive
- Consecutive
Main finding
As reported in the abstract
Stress MBF across CAV severity · Over 2.3±1.0 years
CAV 2 to 3
1.25±0.52
mL/min per g
CAV 0 to 1
2.03±0.81
mL/min per g
P = 0.003
- Stress MBF declined progressively with increasing CAV severity
- P = 0.007
Observational data: associations, not effects.
Further findings
| Outcome | Bravo | Hart | Δ area under the curve | P value |
|---|---|---|---|---|
| Discrimination of advanced CAV, Bravo vs Hart algorithms · paired DeLong comparison; similar discrimination | 0.056 | P = 0.606 | ||
| Area under the curve | 0.773 | 0.717 |
CAV-related event rates by severely reduced coronary flow capacity
- Severely reduced coronary flow capacity vs not
- 28.6% versus 5.2%; P =0.015
CAV-related events by Hart framework
- Exploratory prognostic separation
- 35.3% versus 3.2%; P =0.001
Original publication
Quantitative CZT SPECT Myocardial Blood Flow for Physiological Assessment and Risk Stratification of Cardiac Allograft Vasculopathy. Circ Cardiovasc Imaging. Published 23 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it