Detection of significant coronary artery stenosis with 64-slice computed tomography in heart transplant recipients: a comparative study with conventional coronary angiography

  • Franz von Ziegler
  • Alexander W. Leber
  • Alexander Becker
  • Ingo Kaczmarek
  • Ulf Schönermarck
  • Christine Raps
  • Janine Tittus
  • Peter Überfuhr
  • Christoph R. Becker
  • Maximilian Reiser
  • Gerhard Steinbeck
  • Andreas Knez
Original Paper


Purpose The present study evaluates clinical feasibility of cardiac multidetector computed tomography angiography (MDCTA) to detect significant stenosis of coronary vessels due to transplant vasculopathy (TVP) after heart transplantation (HTx). Methods Twenty-eight consecutive male HTx-recipients scheduled for their annual routine conventional coronary angiography (CCA) additionally underwent 64-slice MDCTA. Results Two patients were excluded from further MDCTA analysis. Out of 371 remaining coronary vessel segments evaluable by CCA, MDCTA was able to depict 302 (81.4%) in diagnostic image quality. On a segment based analysis, sensitivity, specificity, diagnostic accuracy (DA), negative predictive value (NPV), and positive predictive value (PPV) for detection of significant stenosis were calculated with 87.5%, 97.3%, 97.0%, 99.7%, and 46.7%, respectively. On a patient-based evaluation, sensitivity, specificity, DA, NPV, PPV were 100%, 81%, 84.6%, 100% and 55.6%, respectively. Evaluation of stenosis degree by MDCTA showed systematic overestimation of 4.4%. A moderate to good agreement comparing both modalities was found (Pearson’s correlation coefficient: 0.64). Conclusion High NPV suggesting 64-slice MDCTA being a reliable diagnostic tool for ruling out significant stenosis due to TVP in HTx patients. But its clinical value in these particular patients needs further investigation.


Multi-slice computed tomography angiography Conventional coronary angiography Heart transplantation Transplant vasculopathy 


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Copyright information

© Springer Science+Business Media, B.V. 2008

Authors and Affiliations

  • Franz von Ziegler
    • 1
    • 2
  • Alexander W. Leber
    • 1
  • Alexander Becker
    • 1
  • Ingo Kaczmarek
    • 3
  • Ulf Schönermarck
    • 1
  • Christine Raps
    • 3
  • Janine Tittus
    • 1
  • Peter Überfuhr
    • 3
  • Christoph R. Becker
    • 4
  • Maximilian Reiser
    • 4
  • Gerhard Steinbeck
    • 1
  • Andreas Knez
    • 1
  1. 1.Department of CardiologyLudwig-Maximilians-UniversityMunichGermany
  2. 2.University of MunichMunchenGermany
  3. 3.Department of Cardiac SurgeryLudwig-Maximilians-UniversityMunichGermany
  4. 4.Department of Clinical RadiologyLudwig-Maximilians-UniversityMunichGermany

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