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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...

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Autores principales: Tincopa, Monica A., Weinberg, Richard L., Sengupta, Shreya, Slivnick, Jeremy, Corbett, James, Sonnenday, Christopher J., Fontana, Robert J., Sharma, Pratima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8963847/
https://www.ncbi.nlm.nih.gov/pubmed/35372676
http://dx.doi.org/10.1097/TXD.0000000000001311
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author Tincopa, Monica A.
Weinberg, Richard L.
Sengupta, Shreya
Slivnick, Jeremy
Corbett, James
Sonnenday, Christopher J.
Fontana, Robert J.
Sharma, Pratima
author_facet Tincopa, Monica A.
Weinberg, Richard L.
Sengupta, Shreya
Slivnick, Jeremy
Corbett, James
Sonnenday, Christopher J.
Fontana, Robert J.
Sharma, Pratima
author_sort Tincopa, Monica A.
collection PubMed
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/m(2), 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.
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spelling pubmed-89638472022-03-31 The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates Tincopa, Monica A. Weinberg, Richard L. Sengupta, Shreya Slivnick, Jeremy Corbett, James Sonnenday, Christopher J. Fontana, Robert J. Sharma, Pratima Transplant Direct Liver Transplantation 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/m(2), 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. Lippincott Williams & Wilkins 2022-03-25 /pmc/articles/PMC8963847/ /pubmed/35372676 http://dx.doi.org/10.1097/TXD.0000000000001311 Text en Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Liver Transplantation
Tincopa, Monica A.
Weinberg, Richard L.
Sengupta, Shreya
Slivnick, Jeremy
Corbett, James
Sonnenday, Christopher J.
Fontana, Robert J.
Sharma, Pratima
The Utility of Noninvasive PET/CT Myocardial Perfusion Imaging in Adult Liver Transplant Candidates
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
topic Liver Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8963847/
https://www.ncbi.nlm.nih.gov/pubmed/35372676
http://dx.doi.org/10.1097/TXD.0000000000001311
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