New Study Points to Promising Prognostication for Assessing Diffused Cardiac Allograft Vasculopathy

As a follow-up to a recently published paper in the Journal of Nuclear Cardiology, “Noninvasive PET quantitative myocardial blood flow with regadenoson for assessing cardiac allograft vasculopathy in orthotopic heart transplantation patients,” Ernie Garcia, PhD, editor of the journal, spoke with Miguel Hernandez Pampaloni, MD, the first author of the article. The two discussed the paper’s analysis of information from one of the first studies of PET imaging that used regadenoson as a stressor to measure reduced myocardial and coronary blood flow for patients after orthotopic heart transplants.

Pampaloni, who is associate professor in the Department of Radiology and Biomedical Imaging, and chief of nuclear medicine at UCSF, is an expert in the topic with large experience in noninvasively evaluating early coronary blood flow abnormalities in the atherosclerotic process. He spoke of the study’s indications that regadenoson may serve as an effective and non-invasive early tool to evaluate for impaired coronary flow reserve in heart transplant patients, as a sign of diffuse transplant vasculopathy. Pampaloni pointed to regadenoson’s different, more chronotopic, mechanism of action when compared with pure vasodilators, and the ease use as potential advantages.

Pampaloni cautioned that additional testing would be necessary given the limited number of subjects (15) and extensive lapse of time since transplant operations (averaging more than five years). In the interview, however, he was optimistic about the initial results’ indications offering clarification on both global and regional MBFs.

Ideally, a next round study would allow for a protocol with a larger study population and look at individual patients once a year within the first five years after transplantation. Future work could also seek to identify patients with normal coronary arteries but with abnormal blood flow.

Click here to learn more about Dr. Pampaloni’s work in nuclear medicine.

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