936-91 Is Exercise Thallium-201 Imaging Helpful in Risk Stratifying Patients with Cardiac Transplant Coronary Artery Disease?

• Published in: Journal of the American College of Cardiology 1995-02, Vol.25 (2), p.159A-159A
• Main Authors: Rodney, Roxanne A., Moquete, Ellen, Johnson, Lynne L., Barr, Mark L.
• Format: Article
• Language: English
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(95)92112-I

Prior studies have shown that patients with normal exercise SPECT thallium (TI) scans have a favorable prognosis despite the angiographic presence of CAD. Patients with cardiac transplant (Tx) CAD have a high incidence of adverse events including silent MI and sudden death. However given the limited availability of donor hearts. and the lower survival after the second transplant, a technique to risk stratify patients with Tx CAD would be clinically useful and cost-effective. Thirteen patients (mean post-Tx time 40 mo) with angiographic CAD underwent exercise and 4 hr redistribution SPECTTI imaging. Ten patients had epicardial (≥50% diameter reduction) and small vessel disease, two had isolated small vessel disease, and one had isolated epicardial disease. SPECT imaging revealed fixed or reversible defects in 10/13 (77%) patients, 3 patients had normal scans. There was no significant difference in mets achieved during exercise, nor in the extent of CAD between the groups. During a mean follow-up of 20 mo, 8/10 (80%) patients with positive TI scans had graft failure or death vs 0/3(0%) patients with negative TI scans (p<0.05, Kaplan-Meier survival analysis). This preliminary data suggest that SPECT TI imaging may be of value in risk stratifying patients with Tx CAD.