201Tl Myocardial imaging in a cardiac rejection episode

Richter, José; Herreros, Jesús; Serena, Andrés; Pardo, Javier; Azanza, J. R.; Charvet, M. A.; Honorato, J.; Arcas, R

doi:10.1007/bf00253305

Cited by 8 publications

(1 citation statement)

References 9 publications

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“…An influence of acute rejection episodes on 201 Tl uptake has been reported [29,30,31]. Although previous studies demonstrated a rapid normalization of coronary flow reserve and 201 Tl scintigraphy [32, 33],former rejection episodes still play a role on the heterogeneity of 201 Tl SPECT, especially in patients with impaired left ventricular function.…”

Section: Discussionmentioning

confidence: 93%

Usefulness of Progressive Inhomogeneity of Myocardial Perfusion and Chronotropic Incompetence in Detecting Cardiac Allograft Vasculopathy: Evaluation with Dobutamine Thallium-201 Myocardial SPECT

Yen²,

Lee³

et al. 2005

Cardiology

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Background: The aim of the study was to investigate the value of longitudinal follow-up of dobutamine thallium-201 single photon emission tomography (²⁰¹Tl SPECT) in the development of significant cardiac allograft vasculopathy (CAV) after orthotopic heart transplantation. Methods: We studied 38 cardiac recipients (mean age 57 ± 12 years) who underwent at least two follow-up dobutamine ²⁰¹Tl SPECT since January 1998. All patients had normal coronary angiography and normal left ventricular function initially. Results: After 2.3 ± 1.8 years, 12 patients developed significant CAV and there were 4 cardiac deaths (1 died suddenly). Of the 99 scans retrospectively analyzed, patients with significant CAV had elevated values of inhomogeneity score, lung/heart ratio (LHR) at stress and lower left ventricular ejection fraction (all p < 0.05). The higher values of inhomogeneity were significantly correlated with higher stress LHR (r = 0.301, p = 0.021), and lower ejection fraction (r = –0.379, p < 0.001). Progressive inhomogeneity was noted in all heart recipients, and more rapid, although statistically insignificant, in patients who developed significant CAV. Ten patients had inadequate chronotropic response to dobutamine infusion up to 40 µg/kg/min in the follow-up studies. The late onset of chronotropic incompetence was an independent predictor of CAV development (p = 0.03). Conclusions: Progressive inhomogeneity of myocardial perfusion, higher lung uptake at stress and chronotropic incompetence assessed by dobutamine ²⁰¹Tl myocardial SPECT provide incremental diagnostic value in detecting significant CAV.

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Section: Discussionmentioning

confidence: 93%

Usefulness of Progressive Inhomogeneity of Myocardial Perfusion and Chronotropic Incompetence in Detecting Cardiac Allograft Vasculopathy: Evaluation with Dobutamine Thallium-201 Myocardial SPECT

Yen²,

Lee³

et al. 2005

Cardiology

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Heart Transplantation

Rodés¹,

Capdevilla²,

Berini³

et al. 1988

Therapeutics in Cardiology

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201Tl myocardial perfusion in the management of the transplanted heart

Richter¹,

Herreros²,

Serena³

et al. 1990

Eur J Nucl Med

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A semi quantitative method with thallium has been applied in the management of cardiac transplants. In all, 142 scans were performed in 20 patients and were arranged in 3 groups that represent respectively all controls performed to the transplants (G1), and a selection of the scans obtained during the 1st rejection episode in each patient (G2) and the 2nd if present (G3). A heart/lung index was calculated through early and late images (IA, IB), obtained 5 min and 4 h post injection of thallium. A decrease in IA was detected during acute rejection in all groups. This fall was statistically significant from the mild to moderate rejection degree in G1 (P less than 0.01), and the mild rejection in G3 (P less than 0.001). IB was not modified with rejection. Comparing the biopsies with and without edema, in the absence of rejection, it has been proved that the intra myocardial edema can produce a decrease in IA (P less than 0.001). We conclude that IA is a simple and sensitive index to evaluate the graft, although intra myocardial edema can reduce its specificity.

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201Tl Myocardial imaging in a cardiac rejection episode

Cited by 8 publications

References 9 publications

Usefulness of Progressive Inhomogeneity of Myocardial Perfusion and Chronotropic Incompetence in Detecting Cardiac Allograft Vasculopathy: Evaluation with Dobutamine Thallium-201 Myocardial SPECT

Usefulness of Progressive Inhomogeneity of Myocardial Perfusion and Chronotropic Incompetence in Detecting Cardiac Allograft Vasculopathy: Evaluation with Dobutamine Thallium-201 Myocardial SPECT

Heart Transplantation

201Tl myocardial perfusion in the management of the transplanted heart

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