Diagnostic and prognostic role of myocardial perfusion scintigraphy in kidney transplant candidates: narrative review
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.
Coronary artery disease, Kidney transplant, Myocardial scintigraphy
Financial support: No grants or funding have been received for this
Alberto Bestetti Casa di Cura San Pio X Via Nava, 31 20159 Milano, Italy email@example.com
Share this Article
Related Content In Arrhythmia
Radiofrequency Lesion Quality Markers: Current State of Knowledge
European Journal of Arrhythmia & Electrophysiology. 2022;8(1):2-6 DOI: https://doi.org/10.17925/EJAE.2022.8.1.2
Radiofrequency (RF) ablation involves delivering medium-to-high-frequency alternating current, which is electrically conducted to cardiac tissue that constitutes a part of the circuit. The unipolar circuitry contains the generator, transmission lines, catheter, cardiac tissue, interposed tissue and dispersive electrode (ground pad/indifferent electrode). Bipolar systems, whereby the RF current flows between two electrodes, either on the same […]
Remote Monitoring of Cardiac Arrhythmias Using Wearable Digital Technology: Paradigm Shift or Pipe Dream?
European Journal of Arrhythmia & Electrophysiology. 2022;8(1):7-12 DOI: https://doi.org/10.17925/EJAE.2022.8.1.7
Several smart, connected and direct-to-consumer wearable devices capable of detecting cardiac arrhythmias have proliferated in the marketplace in the last decade. Increasingly, these devices are being marketed as “medical grade” in addition to “wellness” devices.1 New iterations of smartwatch and smartphone technology incorporate biosensors and advanced artificial intelligence (AI) algorithms equipped to diagnose cardiac arrhythmias; examples […]
Foreword – European Journal of Arrhythmia & Electrophysiology. 2021;7(1):1
European Journal of Arrhythmia & Electrophysiology. 2021;7(1):1
Welcome to a new issue of the European Journal of Arrhythmia & Electrophysiology. As the ongoing coronavirus disease 2019 (COVID-19) pandemic continues to provide unprecedented challenges for electrophysiologists and other healthcare providers who manage arrhythmias, we hope you find these topical articles interesting and useful. We begin with an editorial from Professor Hugh Calkins and […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!