Redefining CAV surveillance strategies: Benefits of CCTA vs. ICA

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Computed Tomography Pub Date : 2025-01-01 DOI:10.1016/j.jcct.2024.07.004

Valeria Pergola , Nicola Pradegan , Elena Cozza , Dan Alexandru Cozac , Irene Cao , Chiara Tessari , Maria Teresa Savo , Giuseppe Toscano , Annalisa Angelini , Vincenzo Tarzia , Giuseppe Tarantini , Francesco Tona , Giorgio De Conti , Sabino Iliceto , Gino Gerosa , Raffaella Motta

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Abstract

Background

Cardiac allograft vasculopathy (CAV) assessment post-heart transplantation (HT) typically relies on invasive coronary angiography (ICA). However, cardiac computed tomography angiography (CCTA) is emerging as a promising alternative due to its potential benefits in economic, safety, and logistical aspects. This study aimed to evaluate the impact of a CCTA program on these aspects in CAV surveillance post-HT.

Methods

A retrospective single-center study was conducted between March 2021 and February 2023, involving HT patients who underwent either CCTA or ICA.

Results

Among 260 patients undergoing CAV surveillance, 115 (44.2%) patients underwent CCTA, and 145 (55.8%) patients underwent ICA. The CCTA group showed incurred lower overall costs (p < 0.0001) and shorter hospitalization times (p < 0.0001) compared to the ICA group. In terms of safety, CCTA surveillance required significantly lower contrast volumes (p < 0.0001) and lower effective doses (p = 0.03).

Conclusion

CCTA emerges as a safe and cost-effective non-invasive alternative for CAV surveillance post-HT, outperforming ICA in terms of safety, logistical aspects, and economic burden.

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重新定义 CAV 监视策略：CCTA 与 ICA 的优势。

背景：心脏移植术（HT）后的心脏移植血管病变（CAV）评估通常依赖于有创冠状动脉造影术（ICA）。然而，心脏计算机断层扫描血管造影术（CCTA）因其在经济、安全和后勤方面的潜在优势，正在成为一种有前途的替代方法。本研究旨在评估 CCTA 项目对 HT 后 CAV 监测的上述方面的影响：方法：2021 年 3 月至 2023 年 2 月期间进行了一项回顾性单中心研究，涉及接受 CCTA 或 ICA 的 HT 患者：在接受 CAV 监测的 260 例患者中，115 例（44.2%）接受了 CCTA，145 例（55.8%）接受了 ICA。CCTA 组的总费用较低（P 结论：CCTA 是一种安全的血管造影术：CCTA 在安全性、后勤方面和经济负担方面均优于 ICA，是 HT 后 CAV 监测的一种安全、经济的无创替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Computed Tomography CARDIAC & CARDIOVASCULAR SYSTEMS-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.50

自引率

14.80%

发文量

212

审稿时长

40 days

期刊介绍： The Journal of Cardiovascular Computed Tomography is a unique peer-review journal that integrates the entire international cardiovascular CT community including cardiologist and radiologists, from basic to clinical academic researchers, to private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our cardiovascular imaging community across the world. The goal of the journal is to advance the field of cardiovascular CT as the leading cardiovascular CT journal, attracting seminal work in the field with rapid and timely dissemination in electronic and print media.