Noninvasive diagnosis of allograft vascular disease after heart transplantation

Autor: Fernando Bacal, Noedir Antonio Groppo Stolf, Viviane Cordeiro Veiga, William A. Chalela, Cesar Grupi, Ana Clara Rodrigues, Eulógio E. Martinez, Alfredo Inácio Fiorelli, Luiz Felipe Pinho Moreira, Edimar Alcides Bocchi, Giovanni Bellotti, José Antonio Franchini Ramires
Jazyk: English<br />Portuguese
Rok vydání: 2001
Předmět:
Zdroj: Arquivos Brasileiros de Cardiologia, Vol 76, Iss 1, Pp 36-42 (2001)
Druh dokumentu: article
ISSN: 0066-782X
1678-4170
DOI: 10.1590/S0066-782X2001000100004
Popis: OBJECTIVE: To determine the predictive values of noninvasive tests for the detection of allograft vascular disease. METHODS: We studied 39 patients with mean ages of 48±13 years and a follow-up period of 86±13 months. The diagnosis of allograft vascular disease was made by cine-coronary arteriography, and it was considered as positive if lesions existed that caused > or = 50% obstruction of the lumen. Patients underwent 24h Holter monitoring, thallium scintigraphy, a treadmill stress test, and dobutamine stress echocardiography. Sensitivity, specificity, and positive and negative predictive values were determined in percentages for each method, as compared with the cine-coronary arteriography results. RESULTS: Allograft vascular disease was found in 15 (38%) patients. The Holter test showed 15.4% sensitivity, 95.5% specificity. For the treadmill stress test, sensitivity was 10%, specificity was 100%. When thallium scintigraphy was used, sensitivity was 40%, specificity 95.8%. On echocardiography with dobutamine, we found a 63.6% sensitivity, 91.3% specificity. When the dobutamine echocardiogram was associated with scintigraphy, sensitivity was 71.4%, specificity was 87%. CONCLUSION: In this group of patients, the combination of two noninvasive methods (dobutamine echocardiography and thallium scintigraphy) may be a good alternative for the detection of allograft vascular disease in asymptomatic patients with normal ventricular function.
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