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PET Myocardial Blood Flow for Post-transplant Surveillance and Cardiac Allograft Vasculopathy in Heart Transplant Recipients

  • Nuclear Cardiology (V Dilsizian, Section Editor)
  • Published:
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Abstract

Purpose of Review

Cardiac allograft vasculopathy (CAV) is a late-occurring complication of heart transplantation significantly limiting overall graft survival. In the last few years, evidence has been growing about the use of positron emission tomography (PET) myocardial perfusion imaging with integrated myocardial blood flow (MBF) quantification in heart transplant recipients.

Recent Findings

Multiple studies have demonstrated that PET MBF assessment can be utilized to establish the diagnosis of CAV noninvasively and can be employed for prognostication. PET MBF quantification has also helped to define the link between transplant rejection and CAV. In addition, limited data suggests that PET MBF quantification can be used in heart transplant patients for serial monitoring of CAV.

Summary

PET myocardial perfusion imaging integrating MBF quantification shows great promise for the evaluation of CAV with good diagnostic and prognostic performance.

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Abbreviations

CAV:

Cardiac allograft vasculopathy

IVUS:

Intravascular ultrasound

PET:

Positron emission tomography

MBF:

Myocardial blood flow

ISHLT:

International Society of Heart and Lung Transplantation

MFR:

Myocardial flow reserve

MACE:

Major adverse cardiovascular events

IMR:

Index of microcirculatory resistance

CTAC:

Computed tomography attenuation correction

MPI:

Myocardial perfusion imaging

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, Dana 3, P.O. Box 208017, New Haven, CT, 06520, USA

    Attila Feher & Edward J. Miller

  2. Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA

    Attila Feher

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Correspondence to Attila Feher.

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Conflict of Interest

Dr. Feher has nothing to disclose. Dr. Miller reports personal fees from Roivant, Pfizer, and Alnylam and grants from Eidos, Pfizer, Alnylam, and NIH, outside the submitted work.

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Feher, A., Miller, E.J. PET Myocardial Blood Flow for Post-transplant Surveillance and Cardiac Allograft Vasculopathy in Heart Transplant Recipients. Curr Cardiol Rep 24, 1865–1871 (2022). https://doi.org/10.1007/s11886-022-01804-3

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