Significance of abnormal myocardial perfusion scans in candidates for orthotopic liver transplantation

Background: the implications of cardiac risk stratification before orthotopic liver transplantation (olt) are not well established. we studied the usefulness of myocardial perfusion imaging (mpi) in this scenario. methods: mpi data of 24 patients (9 females),candidates of olt,were collected. they underwent mpi as part of their preoperative risk assessment. mpis were interpreted by 2 nuclear physicians,who had access to clinical data,scan,and semi-quantification results (i.e.,quantitative perfusion single-photon emission tomography (spect) [qps] and quantitative gated spect [qgs]). a 3rd nuclear physician,blinded to the clinical history of the subjects,re-reviewed the scans. the visual interpretations of mpi (i.e.,normal vs. abnormal),ejection fraction,and transient ischemic dilation index derived from qps and clinical and follow-up data were collected and analyzed. results: the follow-up period was 231.0 ± 86.0 days. the mpis were normal in 16 (66.7%) patients and abnormal in 8 (i.e.,5 mild [20.8%],1 [4.2%] moderate,and 2 [8.3%] severe). out of 4 patients who died during the follow-up,1 had mild ischemia and 2 had severe ischemia. a patient who had a normal mpi died due to noncardiac reasons. a patient with abnormal mpi had 3-vessel disease on angiography. out of the 5 patients who died or had significant coronary angiographic abnormalities,4 had abnormal mpis (negative predictive value = 93.8%; sensitivity = 80.0%) the mpis of 4 patients without perioperative mortality or cardiac morbidity were abnormal (specificity = 78.9%). conclusion: mpi seems to be remarkable in discriminating high-risk olt patients preoperatively. © 2017,tehran heart center. all rights reserved.