AIMS: To evaluate the accuracy of echocardiography in conjunction with quantitative high-dose dipyridamole @entity1136 sestamibi tomography (SPECT) in detecting @entity301 . METHODS AND RESULTS: Seventy-eight consecutive heart transplant recipients underwent echocardiography while at rest and high-dose dipyridamole SPECT within 48 h of a yearly angiogram. Resting @entity854 were considered significant if present in two or more segments. SPECT was considered abnormal in the presence of reversible/fixed defects. The coronary angiogram was normal in 53, showed non-significant @entity301 in 13 and significant (> or = 50% stenosis) @entity301 in 12 cases. Resting @entity854 were observed in nine cases and perfusion defects in 20. Echocardiography and SPECT were concordant in 59 cases (five positive and 54 negative); in these, accuracy was 100% for significant @entity301 and 83% for any @entity301 . Over 6.5+/-2 years, 17 @entity1 suffered @entity301 -related events, including death in six and retransplantation in three. Resting @entity854 , SPECT perfusion defects and angiographic @entity301 were significant predictors of @entity299 . CONCLUSION: Normal resting wall motion at echocardiography coupled to normal stress myocardial perfusion, rules out the presence of significant @entity301 in many heart transplant recipients. Conversely, resting @entity854 and perfusion defects strongly predict @entity299 . Therefore, a strategy which reserves angiography for @entity1 with resting @entity854 and/or perfusion defects may be safe and cost-effective.

Resting echocardiography and quantitative dipyridamole XXXX sestamibi tomography in the identification of @entity299 and the prediction of long-term prognosis after heart transplantation.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1136 :: ('MESH:D013667', 'Chemical') :: ['technetium-99m'] @entity301 :: ('MESH:D003327', 'Disease') :: ['coronary allograft vasculopathy'] @entity854 :: ('MESH:D018376', 'Disease') :: ['wall motion abnormalities'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac events']
@entity1136 :: (MESH:D013667,Chemical) :: ['technetium-99m']
