Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Moaz A. Kamel; Isabel G. Scalia; Amro T. Badr; Nima Baba Ali; Juan M. Farina; Milagros Pereyra; Mohammed Tiseer Abbas; Ahmed K. Mahmoud; Robert L Scott; David E. Steidley; Julie L. Rosenthal; Lisa M. Lemond; Kristen A. Sell-Dottin; Brian W. Hardaway; Timothy Barry; Ming Yang; Chieh Ju Chao; Clinton E. Jokerst; Chadi Ayoub; Reza Arsanjani

doi:10.3390/jcdd11030095

Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Moaz A. Kamel, Isabel G. Scalia, Amro T. Badr, Nima Baba Ali, Juan M. Farina, Milagros Pereyra, Mohammed Tiseer Abbas, Ahmed K. Mahmoud, Robert L Scott, David E. Steidley, Julie L. Rosenthal, Lisa M. Lemond, Kristen A. Sell-Dottin, Brian W. Hardaway, Timothy Barry, Ming Yang, Chieh Ju Chao, Clinton E. Jokerst, Chadi Ayoub, Reza Arsanjani

Cardiovascular Diseases

Research output: Contribution to journal › Review article › peer-review

Abstract

Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity. However, these tests are invasive and are unable to visualize and evaluate coronary microcirculation. Increasing evidence for non-invasive surveillance techniques assessing both epicardial and microvascular components of CAV may help improve early detection. These include computed tomography coronary angiography (CTCA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and vasodilator stress myocardial contrast echocardiography perfusion imaging. This review summarizes the current state of diagnostic modalities and their utility and prognostic value for CAV and also evaluates emerging tools that may improve the early detection of this complex disease.

Original language	English (US)
Article number	95
Journal	Journal of Cardiovascular Development and Disease
Volume	11
Issue number	3
DOIs	https://doi.org/10.3390/jcdd11030095
State	Published - Mar 2024

Keywords

angiography
cardiac allograft vasculopathy
echocardiography
nuclear imaging

ASJC Scopus subject areas

General Pharmacology, Toxicology and Pharmaceutics
Pharmacology (medical)

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10.3390/jcdd11030095

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Kamel, M. A., Scalia, I. G., Badr, A. T., Baba Ali, N., Farina, J. M., Pereyra, M., Abbas, M. T., Mahmoud, A. K., Scott, R. L., Steidley, D. E., Rosenthal, J. L., Lemond, L. M., Sell-Dottin, K. A., Hardaway, B. W., Barry, T., Yang, M., Chao, C. J., Jokerst, C. E., Ayoub, C., & Arsanjani, R. (2024). Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities. Journal of Cardiovascular Development and Disease, 11(3), Article 95. https://doi.org/10.3390/jcdd11030095

Kamel, MA, Scalia, IG, Badr, AT, Baba Ali, N, Farina, JM, Pereyra, M, Abbas, MT, Mahmoud, AK, Scott, RL , Steidley, DE, Rosenthal, JL, Lemond, LM, Sell-Dottin, KA, Hardaway, BW, Barry, T, Yang, M, Chao, CJ, Jokerst, CE, Ayoub, C & Arsanjani, R 2024, 'Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities', Journal of Cardiovascular Development and Disease, vol. 11, no. 3, 95. https://doi.org/10.3390/jcdd11030095

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abstract = "Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity. However, these tests are invasive and are unable to visualize and evaluate coronary microcirculation. Increasing evidence for non-invasive surveillance techniques assessing both epicardial and microvascular components of CAV may help improve early detection. These include computed tomography coronary angiography (CTCA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and vasodilator stress myocardial contrast echocardiography perfusion imaging. This review summarizes the current state of diagnostic modalities and their utility and prognostic value for CAV and also evaluates emerging tools that may improve the early detection of this complex disease.",

keywords = "angiography, cardiac allograft vasculopathy, echocardiography, nuclear imaging",

author = "Kamel, {Moaz A.} and Scalia, {Isabel G.} and Badr, {Amro T.} and {Baba Ali}, Nima and Farina, {Juan M.} and Milagros Pereyra and Abbas, {Mohammed Tiseer} and Mahmoud, {Ahmed K.} and Scott, {Robert L} and Steidley, {David E.} and Rosenthal, {Julie L.} and Lemond, {Lisa M.} and Sell-Dottin, {Kristen A.} and Hardaway, {Brian W.} and Timothy Barry and Ming Yang and Chao, {Chieh Ju} and Jokerst, {Clinton E.} and Chadi Ayoub and Reza Arsanjani",

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AU - Kamel, Moaz A.

AU - Scalia, Isabel G.

AU - Badr, Amro T.

AU - Baba Ali, Nima

AU - Farina, Juan M.

AU - Pereyra, Milagros

AU - Abbas, Mohammed Tiseer

AU - Mahmoud, Ahmed K.

AU - Scott, Robert L

AU - Steidley, David E.

AU - Rosenthal, Julie L.

AU - Lemond, Lisa M.

AU - Sell-Dottin, Kristen A.

AU - Hardaway, Brian W.

AU - Barry, Timothy

AU - Yang, Ming

AU - Chao, Chieh Ju

AU - Jokerst, Clinton E.

AU - Ayoub, Chadi

AU - Arsanjani, Reza

PY - 2024/3

Y1 - 2024/3

N2 - Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity. However, these tests are invasive and are unable to visualize and evaluate coronary microcirculation. Increasing evidence for non-invasive surveillance techniques assessing both epicardial and microvascular components of CAV may help improve early detection. These include computed tomography coronary angiography (CTCA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and vasodilator stress myocardial contrast echocardiography perfusion imaging. This review summarizes the current state of diagnostic modalities and their utility and prognostic value for CAV and also evaluates emerging tools that may improve the early detection of this complex disease.

AB - Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity. However, these tests are invasive and are unable to visualize and evaluate coronary microcirculation. Increasing evidence for non-invasive surveillance techniques assessing both epicardial and microvascular components of CAV may help improve early detection. These include computed tomography coronary angiography (CTCA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and vasodilator stress myocardial contrast echocardiography perfusion imaging. This review summarizes the current state of diagnostic modalities and their utility and prognostic value for CAV and also evaluates emerging tools that may improve the early detection of this complex disease.

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KW - cardiac allograft vasculopathy

KW - echocardiography

KW - nuclear imaging

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Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

Abstract

Keywords

ASJC Scopus subject areas

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