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Feasibility and accuracy of SPECT myocardial perfusion imaging in end-stage lung disease

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Coronary artery disease (CAD) is associated with increased mortality in patients with chronic lung disease. However, non-invasive diagnostic of CAD is difficult, especially in patients with more advanced disease. Therefore, we aimed to assess the feasibility and accuracy of SPECT-myocardial perfusion imaging (MPI) stress testing with regadenoson in patients with end-stage lung disease (ELD) undergoing assessment of stable CAD.

Methods

Between January 2012 and May 2018, 102 patients with ELD, who were referred to our institution for lung transplant evaluation, were assessed retrospectively. All patients underwent both stress SPECT-MPI as well as coronary angiography.

Results

The mean age in our population was 57±6 years. All patients had severe pulmonary function impairment. During stress SPECT-MPI 14 patients (14%) reported regadenoson-related symptoms, but only 2 patients (2%) required medical treatment. Coronary angiography revealed obstructive CAD in 20 patients (20%). Among those, 5 patients had abnormal SPECT-MPI and PCI was performed in 3 patients accordingly. In 14 patients with obstructive CAD, revascularization was deferred based on normal SPECT-MPI findings.

Conclusions

SPECT-MPI using regadenoson is well tolerated in patients with ELD and can help to make decisions about coronary revascularization before lung transplant.

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Abbreviations

CAD:

Coronary artery disease

CAG:

Coronary angiography

CAC:

Coronary artery calcium score

COPD:

chronic obstructive pulmonary disease

ELD:

End-stage lung disease

FFR:

Fractional flow reserve

ILD:

Interstitial lung disease

MPI:

Myocardial perfusion imaging

RCA:

Right coronary artery

SPECT:

Single-photon emission computed tomography

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Disclosure

The authors declare that they have no conflict of interest connected with this work.

Author information

Author notes

  1. Sanziana R. I. Schiopu and Mathias Zacherl share first authorship.

  2. Bruno C. Huber and Nikolaus Kneidinger share senior authorship.

Authors and Affiliations

  1. Department of Internal Medicine V, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Sanziana R. I. Schiopu MD, Katrin Milger MD, Gabriela Leuschner MD, Dieter Munker MD, Jürgen Behr MD & Nikolaus Kneidinger MD, PhD

  2. Comprehensive Pneumology Centre (CPC-M), Member of the German Centre for Lung Research (DZL), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Sanziana R. I. Schiopu MD, Katrin Milger MD, Gabriela Leuschner MD, Dieter Munker MD, Jürgen Behr MD & Nikolaus Kneidinger MD, PhD

  3. Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Marchioninistrasse. 15, 81377, Munich, Germany

    Mathias Zacherl MD, Andrei Todica MD & Peter Bartenstein MD

  4. Medical Controlling Unit, Department for Patient Management, Munich University Hospital (TM), 81366, Munich, Germany

    Matthäus Bauer MD

  5. Medical Department I, Campus Grosshadern and Campus Innenstadt, Ludwig-Maximilians-University, Munich, Marchioninistrasse 15, Munich, Germany

    Steffen Massberg MD & Bruno C. Huber MD

  6. Asklepios Clinic München, Gauting, Germany

    Jürgen Behr MD

  7. Department for Pneumology and Respiratory Medicine, Robert-Bosch-Hospital, Schillerhöhe Clinic, Solitudestr. 18, 70839, Gerlingen, Germany

    Claus Neurohr MD

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  1. Sanziana R. I. Schiopu MD
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Correspondence to Sanziana R. I. Schiopu MD.

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Schiopu, S.R.I., Zacherl, M., Todica, A. et al. Feasibility and accuracy of SPECT myocardial perfusion imaging in end-stage lung disease. J. Nucl. Cardiol. 27, 903–911 (2020). https://doi.org/10.1007/s12350-019-01851-4

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