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Feasibility and accuracy of SPECT myocardial perfusion imaging in end-stage lung disease

Sanziana R I Schiopu1,2, Mathias Zacherl3, Andrei Todica3

  • 1Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany. schiopu_s@yahoo.com.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|August 21, 2019
PubMed

Insights

Regadenoson stress SPECT-myocardial perfusion imaging (MPI) is safe and effective for diagnosing coronary artery disease (CAD) in patients with end-stage lung disease (ELD). This non-invasive test aids in pre-lung transplant decisions.

Area of Science:

  • Cardiology
  • Pulmonology
  • Nuclear Medicine

Background:

  • Coronary artery disease (CAD) increases mortality in patients with chronic lung disease.
  • Non-invasive CAD diagnosis is challenging in advanced lung disease.
  • End-stage lung disease (ELD) patients require accurate CAD assessment for lung transplant eligibility.

Purpose of the Study:

  • To evaluate the feasibility and accuracy of SPECT-myocardial perfusion imaging (MPI) stress testing using regadenoson in ELD patients.
  • To assess the safety and tolerability of regadenoson-induced stress SPECT-MPI in this population.
  • To determine the utility of SPECT-MPI in guiding revascularization decisions before lung transplantation.

Main Methods:

  • Retrospective analysis of 102 ELD patients undergoing lung transplant evaluation (January 2012 - May 2018).
  • All patients underwent stress SPECT-myocardial perfusion imaging (MPI) with regadenoson and coronary angiography.
  • Data on regadenoson-related symptoms and coronary angiography findings were collected.

Main Results:

  • Regadenoson stress SPECT-MPI was well-tolerated, with only 14% experiencing mild symptoms and 2% requiring treatment.
  • Obstructive CAD was identified in 20% of patients.
  • SPECT-MPI findings influenced revascularization decisions in 14 patients with obstructive CAD.

Conclusions:

  • Regadenoson-enhanced SPECT-MPI is a feasible and safe diagnostic tool for CAD in ELD patients.
  • The imaging modality aids in clinical decision-making regarding coronary revascularization prior to lung transplantation.
  • SPECT-MPI can help optimize patient selection for lung transplantation by identifying significant CAD.
Abstract

Keywords:
COPDILDSPECTcoronary artery diseasemyocardial perfusion imagingstress testing

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