ArticleJournal of the American College of Cardiology2022
Noninvasive Physiologic Assessment of Cardiac Allograft Vasculopathy Is Prognostic for Post-Transplant Events.
Article in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 36 citations in OpenAlex.
- Non-invasive imaging in heart transplant recipients: state of art and future direction.European journal of nuclear medicine and molecular imaging · 2026Review
- Discharge AI-ECG-Derived Age and Incidence of Cardiac Allograft Vasculopathy at 3 Years: A Pilot Study.Journal of cardiovascular development and disease · 2026Article
- Myocardial perfusion reserve is low in heart transplant patients and is related to exercise capacity.Clinical physiology and functional imaging · 2026Article
- Endothelial PTBP1 Deletion in Transplanted Cardiac Tissue Limits Cardiac Allograft Vasculopathy.bioRxiv : the preprint server for biology · 2026Article
- Regulatory T cells in cardiac allograft vasculopathy: from mechanistic insights to clinical tolerance.Frontiers in immunology · 2026Review
- Can the grading of mild cardiac allograft vasculopathy be further refined? An angiographic and physiologic assessment of heart transplant recipients with ISHLT CAV 1.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025Article
- PET/CT with Myocardial Blood Flow Assessment Is Prognostic of Cardiac Allograft Vasculopathy Progression and Clinical Outcomes.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025Article
- Elevated Donor-Derived Cell-Free DNA Levels Are Associated With Reduced Myocardial Blood Flow but Not Angiographic Cardiac Allograft Vasculopathy: The EVIDENT Study.Circulation. Heart failure · 2025Article
- Revisiting Biomarkers of Cardiac Allograft Vasculopathy: Addressing the Achilles Heel of Heart Transplantation.Current heart failure reports · 2024Review
- Added prognostic value of visually estimated coronary artery calcium among heart transplant recipients.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Cytomegalovirus infection is associated with impaired myocardial flow reserve after heart transplantation.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Functional Assessment of Long-Term Microvascular Cardiac Allograft Vasculopathy.Journal of personalized medicine · 2023Article
- Cardiac allograft vasculopathy diagnosed by vasodilator myocardial contrast echocardiography perfusion imaging.ESC heart failure · 2023Article
- The Role of Cardiac PET in Diagnosis and Prognosis of Ischemic Heart Disease: Optimal Modality Across Different Patient Populations.Current atherosclerosis reports · 2023Review
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18 authors at 2 institutions in 1 country.
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Abstract
backgroundCardiac allograft vasculopathy (CAV) causes impaired blood flow in both epicardial coronary arteries and the microvasculature. A leading cause of post-transplant mortality, CAV affects 50% of heart transplant recipients within 10 years of heart transplant.
objectivesThis analysis examined the outcomes of heart transplant recipients with reduced myocardial blood flow reserve (MBFR) and microvascular CAV detected by
methodsA total of 181 heart transplant recipients who underwent PET to assess for CAV were included with a median follow-up of 4.7 years. Patients were classified into 2 groups according to the total MBFR: >2.0 and ≤2.0. Microvascular CAV was defined as no epicardial CAV detected by PET and/or coronary angiography, but with an MBFR ≤2.0 by PET.
resultsIn total, 71 (39%) patients had an MBFR ≤2.0. Patients with an MBFR ≤2.0 experienced an increased risk for all outcomes: 7-fold increase in death or retransplantation (HR: 7.05; 95% CI: 3.2-15.6; P < 0.0001), 12-fold increase in cardiovascular death (HR: 12.0; 95% CI: 2.64-54.12; P = 0.001), and 10-fold increase in cardiovascular hospitalization (HR: 10.1; 95% CI: 3.43-29.9; P < 0.0001). The 5-year mean survival was 302 days less than those with an MBFR >2.0 (95% CI: 260.2-345.4 days; P < 0.0001). Microvascular CAV (adjusted HR: 3.86; 95% CI: 1.58-9.40; P = 0.003) was independently associated with an increased risk of death or retransplantation.
conclusionsAbnormal myocardial blood flow reserve, even in the absence of epicardial CAV, identifies patients at a high risk of death or retransplantation. Measures of myocardial blood flow provide prognostic information in addition to traditional CAV assessment.
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