Trending Topic

15 mins

Trending Topic

Developed by Touch
Mark CompleteCompleted
BookmarkBookmarked

Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1 Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2 It is conventionally performed via the trans-femoral (TF) route. Recently, however, the trans-radial (TR) route has become the preferred way.3 The TR route offers better procedure comfort, shorter hospitalization […]

< 1 min

Diagnostic and prognostic role of myocardial perfusion scintigraphy in kidney transplant candidates: narrative review

Alberto Bestetti, Antonella Capozza, Simona Malaspina, Francesco Laudicina, Maurizio Gallieni
Share
Facebook
X (formerly Twitter)
LinkedIn
Via Email
Mark CompleteCompleted
BookmarkBookmarked
Copy LinkLink Copied
Download as PDF
Published Online: Aug 20th 2018 Heart International. 2016;11(1):e50-e55 DOI: https://doi.org/10.5301/heartint.5000233
Select a Section…
1

Abstract

Overview

Purpose.
Cardiac screening in adult kidney transplant candidates with myocardial perfusion scintigraphy (MPS)
can reveal findings associated with increased risk for coronary heart disease events, but the exact value of this
screening test is still undetermined.
Methods.
Narrative review based on the available literature and guidelines on the yield, benefits, and harms of
MPS screening in kidney transplant candidates.
Results.
Although coronary angiography carries low risk in general population, it is not without risk particularly in patients with complex comorbid disease and the use of intravenous contrast media may precipitate
a need for hospitalization and death. We could avoid invasive coronary angiography in patients with chronic
kidney disease, although with high coronary calcium score, but good left ventricle function and normal perfusion, evaluated by Gated single-photon emission computed tomographic (SPECT) MPS. In fact, although
Gated SPECT MPS has not a high sensitivity, it provides some variables that are closely related to sudden
death: post-stress and rest-ejection fraction and left ventricular volumes, left ventricle muscle mass, extent
of ischemia and scar.
Conclusions.
Gated SPECT MPS is a valid noninvasive cardiac screening test. It can be used as alternative to stress
echocardiography in kidney transplant candidates with high cardiovascular risk and a positive or inconclusive
exercise tolerance ECG test.
Patients with abnormal perfusion and cardiac dysfunction should undergo invasive coronary artery imaging and
endovascular treatment, while angiography could be avoided in patients with normal MPI, having good long-term
prognosis.

Keywords

Coronary artery disease, Kidney transplant, Myocardial scintigraphy

2

Article Information

Disclosure

Financial support: No grants or funding have been received for this
study.

Correspondence

Alberto Bestetti Casa di Cura San Pio X Via Nava, 31 20159 Milano, Italy alberto.bestetti@unimi.it

3

Further Resources

Share
Facebook
X (formerly Twitter)
LinkedIn
Via Email
Mark CompleteCompleted
BookmarkBookmarked
Copy LinkLink Copied
Download as PDF
Close Popup