The Role of Multimodality Cardiac Imaging in the Transplanted Heart

• Published in: JACC. Cardiovascular imaging Vol. 2; no. 9; pp. 1126 - 1140
• Main Authors: Estep, Jerry D., MD, Shah, Dipan J., MD, Nagueh, Sherif F., MD, Mahmarian, John J., MD, Torre-Amione, Guillermo, MD, PhD, Zoghbi, William A., MD
• Format: Journal Article
• Language: English
• Published: United States 01.09.2009
• Subjects: Acute Disease; Adult; Cardiovascular; Diagnostic Imaging - methods; Echocardiography; Graft Rejection - diagnosis; Graft Rejection - etiology; Heart Failure - pathology; Heart Failure - surgery; Heart Transplantation; Humans; Magnetic Resonance Imaging; Myocardial Perfusion Imaging; Myocardium - pathology; Predictive Value of Tests; Prognosis; Time Factors; Tomography, X-Ray Computed; Transplantation, Homologous; Treatment Outcome; major adverse cardiac events; intravascular ultrasound; LV; HT; tissue Doppler imaging; SPECT-MPI; MACE; multidetector computed tomography; DSE; TDI; EMB; left ventricular; heart transplantation; single-photon emission computed tomography-myocardial perfusion imaging; cardiac imaging; CMR; IVUS; dobutamine stress echocardiography; acute cellular rejection; MDCT; ACR; cardiac allograft vasculopathy; endomyocardial biopsy; heart transplant; CAV; vasculopathy; cardiac magnetic resonance
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2009.06.006

Heart transplantation (HT) is an established life-saving treatment option for patients with end-stage heart failure. Despite many advances in the field, the development of acute cellular rejection (ACR) and cardiac allograft vasculopathy (CAV) represent significant causes of 1- and 5-year morbidity and mortality, respectively. The search for noninvasive techniques to assess cardiac allograft function and detect treatable ACR and CAV remains a priority objective for heart transplant professionals. In this review we will: 1) highlight the clinical significance of ACR and CAV in adult cardiac transplant recipients and 2) discuss how different noninvasive imaging modalities (echocardiography, cardiac computed tomography, myocardial perfusion imaging, and cardiac magnetic resonance) have been used in the evaluation of these clinical challenges after HT.