The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates
Background. The optimal cardiovascular (CV) risk stratification in liver transplant (LT) candidates remains unclear. The aim of this study was to evaluate concordance of findings between dobutamine stress echocardiography (DSE), positron emission tomography/computed tomography myocardial perfusion i...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-04-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001311 |
| _version_ | 1818744540245262336 |
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| author | Monica A. Tincopa, MD Richard L. Weinberg, MD Shreya Sengupta, MD Jeremy Slivnick, MD James Corbett, MD Christopher J. Sonnenday, MD, MS Robert J. Fontana, MD Pratima Sharma, MD |
| author_facet | Monica A. Tincopa, MD Richard L. Weinberg, MD Shreya Sengupta, MD Jeremy Slivnick, MD James Corbett, MD Christopher J. Sonnenday, MD, MS Robert J. Fontana, MD Pratima Sharma, MD |
| author_sort | Monica A. Tincopa, MD |
| collection | DOAJ |
| description | Background. The optimal cardiovascular (CV) risk stratification in liver transplant (LT) candidates remains unclear. The aim of this study was to evaluate concordance of findings between dobutamine stress echocardiography (DSE), positron emission tomography/computed tomography myocardial perfusion imaging (PET/CT MPI), and left heart catheterization in adult LT candidates.
Methods. Data on 234 consecutive adult LT candidates from February 2015 to June 2018 with PET/CT MPI were reviewed. Adverse CV outcomes were adjudicated via chart review by a board-certified cardiologist.
Results. Median age was 60.8, body mass index 30.2 kg/m2, and model of end-stage liver disease–sodium 14; 61% were male, and 54% had diabetes. Thirty-seven percent had nonalcoholic steatohepatitis and 29% alcohol-related liver disease. Sixty-five percent of patients had a DSE, of which 41% were nondiagnostic. No factors were independently associated with having a nondiagnostic DSE. The median global myocardial flow reserve correlated positively with hemoglobin and negatively with model of end-stage liver disease–sodium, age, ejection fraction, and body mass index. Moderate/high-risk MPIs were associated with older age and known CV disease. In patients with 2 cardiac testing modalities, findings were concordant in 87%. Eleven of 53 LT recipients experienced an adverse CV outcome, but no independent predictors were identified for this outcome.
Conclusions. Results of different cardiac risk-stratification modalities were concordant across modalities the majority of the time in LT candidates, although these findings were not independently correlated with risk of post-LT CV outcomes. Given the high rates of nondiagnostic DSEs in this population, PET/CT MPI may be the preferred CV risk-stratification modality in older patients and those with known CV disease. |
| first_indexed | 2024-12-18T02:45:56Z |
| format | Article |
| id | doaj.art-3c42135c643b409f893860b1e9acc7b3 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-12-18T02:45:56Z |
| publishDate | 2022-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-3c42135c643b409f893860b1e9acc7b32022-12-21T21:23:33ZengWolters KluwerTransplantation Direct2373-87312022-04-0184e131110.1097/TXD.0000000000001311202204000-00011The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant CandidatesMonica A. Tincopa, MD0Richard L. Weinberg, MD1Shreya Sengupta, MD2Jeremy Slivnick, MD3James Corbett, MD4Christopher J. Sonnenday, MD, MS5Robert J. Fontana, MD6Pratima Sharma, MD71 Department of Internal Medicine, Division of Digestive Diseases, UCLA Health, Los Angeles, CA.2 Division of Cardiovascular Medicine, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.3 Division of Gastroenterology and Hepatology, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.4 Division of Cardiovascular Medicine, Ohio State University Wexner Medical Center, Columbus, OH.2 Division of Cardiovascular Medicine, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.3 Division of Gastroenterology and Hepatology, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.3 Division of Gastroenterology and Hepatology, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.3 Division of Gastroenterology and Hepatology, Department of Surgery, University of Michigan Health System, Ann Arbor, MI.Background. The optimal cardiovascular (CV) risk stratification in liver transplant (LT) candidates remains unclear. The aim of this study was to evaluate concordance of findings between dobutamine stress echocardiography (DSE), positron emission tomography/computed tomography myocardial perfusion imaging (PET/CT MPI), and left heart catheterization in adult LT candidates. Methods. Data on 234 consecutive adult LT candidates from February 2015 to June 2018 with PET/CT MPI were reviewed. Adverse CV outcomes were adjudicated via chart review by a board-certified cardiologist. Results. Median age was 60.8, body mass index 30.2 kg/m2, and model of end-stage liver disease–sodium 14; 61% were male, and 54% had diabetes. Thirty-seven percent had nonalcoholic steatohepatitis and 29% alcohol-related liver disease. Sixty-five percent of patients had a DSE, of which 41% were nondiagnostic. No factors were independently associated with having a nondiagnostic DSE. The median global myocardial flow reserve correlated positively with hemoglobin and negatively with model of end-stage liver disease–sodium, age, ejection fraction, and body mass index. Moderate/high-risk MPIs were associated with older age and known CV disease. In patients with 2 cardiac testing modalities, findings were concordant in 87%. Eleven of 53 LT recipients experienced an adverse CV outcome, but no independent predictors were identified for this outcome. Conclusions. Results of different cardiac risk-stratification modalities were concordant across modalities the majority of the time in LT candidates, although these findings were not independently correlated with risk of post-LT CV outcomes. Given the high rates of nondiagnostic DSEs in this population, PET/CT MPI may be the preferred CV risk-stratification modality in older patients and those with known CV disease.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001311 |
| spellingShingle | Monica A. Tincopa, MD Richard L. Weinberg, MD Shreya Sengupta, MD Jeremy Slivnick, MD James Corbett, MD Christopher J. Sonnenday, MD, MS Robert J. Fontana, MD Pratima Sharma, MD The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates Transplantation Direct |
| title | The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates |
| title_full | The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates |
| title_fullStr | The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates |
| title_full_unstemmed | The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates |
| title_short | The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates |
| title_sort | utility of noninvasive pet ct myocardial perfusion imaging in adult liver transplant candidates |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001311 |
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