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

Curr Cardiol Rep. 2022 Dec;24(12):1865-1871. doi: 10.1007/s11886-022-01804-3. Epub 2022 Oct 24.

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

Keywords: Cardiac allograft vasculopathy; Coronary microcirculation; Heart transplantation; Myocardial blood flow; Myocardial flow reserve; Positron emission tomography.

Publication types

  • Review

MeSH terms

  • Allografts / diagnostic imaging
  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / etiology
  • Heart Transplantation* / methods
  • Humans
  • Myocardial Perfusion Imaging* / methods
  • Positron-Emission Tomography / methods