ABNORMAL AMBULATORY LEFT-VENTRICULAR EJECTION FRACTION IN HEART-TRANSPLANT ARTERIOPATHY

The morbidity and mortality from heart transplantation has been reduce d dramatically over the last several years. However, the long-term sur vival in heart transplant recipients is limited by arteriopathy in the allograft coronary arteries, the pathophysiology of which is poorly u nderstood. The diagnosis of this arteriopathy is at present limited to cardiac catheterization. Noninvasive studies have proven to be of lim ited benefit in diagnosing this arteriopathy. The authors performed ca rdiac vest studies in nine heart transplant recipient patients. Six of the vest studies were abnormal; five of the patients had documented t ransplant coronary artery disease by cardiac catheterization. They fou nd that the sensitivity and negative predictive value of the cardiac v est in identifying arteriopathy in transplant recipients was 100%. The authors propose that cardiac vest could be a sensitive, noninvasive s creening test for identifying arteriopathy in heart transplant recipie nts.