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Exercise echocardiography, angiography, and intracoronary ultrasound after cardiac transplantation

Fifty-one consecutive patients underwent exercise echocardiography, angiography, and intracoronary ultrasound (ICUS) 2.5 years (range 1 to 6) after cardiac transplantation. The average age of the donor was 29 years (range 13 to 50), and the average age of the recipient was 49 ± 12 years. In total, 7...

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Published in:The American journal of cardiology 1996-06, Vol.77 (14), p.1216-1219
Main Authors: Cohn, Joel M., Wilensky, Robert L, O'Donnell, Jacqueline A., Bourdillon, Patrick D.V., Dillon, James C., Feigenbaum, Harvey
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description Fifty-one consecutive patients underwent exercise echocardiography, angiography, and intracoronary ultrasound (ICUS) 2.5 years (range 1 to 6) after cardiac transplantation. The average age of the donor was 29 years (range 13 to 50), and the average age of the recipient was 49 ± 12 years. In total, 78 studies were performed, as 25 patients had >1 annual evaluation and 2 patients had 3 consecutive annual evaluations. Of the 78 angiographic studies, 40 (26 patients) had evidence of coronary artery disease, defined as a focal stenosis (>20%, n = 4) or luminal irregularities (n = 36). However, by ICUS all 51 patients had intimal thickening at some point, with 34 patients possessing diffuse disease and 17 focal intimal thickening only. Of the 25 serial studies, 12 progressed by at least 1 Stanford class. The sensitivity of angiography for the determination of class III to IV intimal thickening was 64%, and the specificity was 76%. On exercise echocardiography, 6 examinations revealed resting wall motion abnormalities, whereas 6 had inducible wall motion abnormalities with exercise. The sensitivity of exercise echocardiography to determine class III to IV intimal thickening was 15%, and the specificity was 85%. In conclusion, exercise echocardiography is an insensitive method for predicting transplant-mediated coronary artery disease, whereas luminal irregularities on angiography may predict the presence of Stanford grade III to IV intimal thickening.
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identifier ISSN: 0002-9149
ispartof The American journal of cardiology, 1996-06, Vol.77 (14), p.1216-1219
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source ScienceDirect Journals
subjects Adult
Biological and medical sciences
Cardiovascular disease
Constriction, Pathologic
Coronary Angiography
Coronary Disease - diagnosis
Echocardiography
Exercise Test
Female
Heart
Heart Transplantation - diagnostic imaging
Humans
Male
Medical imaging
Medical sciences
Middle Aged
Postoperative Complications - diagnosis
Prospective Studies
Sensitivity and Specificity
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Transplants & implants
Ultrasonography, Interventional
title Exercise echocardiography, angiography, and intracoronary ultrasound after cardiac transplantation
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