Coronary disease & ACSCohort study
Quantitative Cadmium-zinc-telluride (CZT) Single-photon Emission Computed Tomography (SPECT) Myocardial Blood Flow for Physiological Assessment and Risk Stratification of Cardiac Allograft Vasculopathy
- retrospective study
- consecutive
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
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:10.1161/circimaging.126.019747
Summarised from the published abstract; every number is checked against it