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Imaging Coronary Allograft Vasculopathy with Cardiac PET and Cardiac MRI

Chaitanya Madamanchi1, Matthew C Konerman2, Venkatesh L Murthy2

  • 1Frankel Cardiovascular Center, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. cmadaman@med.umich.edu.

Current Cardiology Reports
|October 17, 2021
PubMed

Insights

Cardiac positron emission tomography (PET) and cardiac magnetic resonance imaging (CMR) show promise for diagnosing and predicting coronary allograft vasculopathy (CAV) in heart transplant recipients. These advanced imaging techniques aid in early detection and monitoring of this critical condition.

Area of Science:

  • Cardiology
  • Transplant Medicine
  • Medical Imaging

Background:

  • Coronary allograft vasculopathy (CAV) significantly impacts heart transplant patient outcomes.
  • Early CAV is often asymptomatic, posing diagnostic challenges.
  • CAV affects both major coronary arteries and microvasculature.

Purpose of the Study:

  • To review the diagnostic and prognostic roles of cardiac positron emission tomography (PET) and cardiac magnetic resonance imaging (CMR) in CAV.
  • To highlight the utility of advanced imaging in managing heart transplant recipients.

Main Methods:

  • Review of current literature on cardiac PET and CMR for CAV.
  • Discussion of relative myocardial perfusion imaging (MPI) and quantitative myocardial blood flow with PET.
  • Analysis of late gadolinium enhancement (LGE) and quantitative CMR measures.

Main Results:

  • Cardiac PET (MPI, quantitative flow) is valuable for CAV diagnosis and prognosis.
  • Cardiac CMR (LGE, perfusion reserve, diastolic rate) also aids in CAV assessment.
  • PET is established for CAV screening and monitoring; CMR shows significant promise.

Conclusions:

  • Cardiac PET and CMR are crucial non-invasive tools for CAV detection and management.
  • Further large-scale, multicenter studies are needed to confirm clinical impact and optimize therapy.
  • Serial imaging with PET and CMR can improve outcomes by enabling early intervention.
Abstract

Keywords:
Coronary allograft vasculopathyMagnetic resonance imagingPositron emission tomography

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