Diagnóstico não-invasivo da doença vascular do enxerto após transplante cardíaco / Noninvasive diagnosis of allograft vascular disease after heart transplantation

RESUMO

OBJECTIVE: To determine the predictive values of noninvasive tests for the detection of allograft vascular disease. METHODS: We studied 39 patients with mean ages of 48Ý13 years and a follow-up period of 86Ý13 months. The diagnosis of allograft vascular disease was made by cine-coronary arteriography, and it was considered as positive if lesions existed that caused > or = 50 percent obstruction of the lumen. Patients underwent 24h Holter monitoring, thallium scintigraphy, a treadmill stress test, and dobutamine stress echocardiography. Sensitivity, specificity, and positive and negative predictive values were determined in percentages for each method, as compared with the cine-coronary arteriography results. RESULTS: Allograft vascular disease was found in 15 (38 percent) patients. The Holter test showed 15.4 percent sensitivity, 95.5 percent specificity...