The pressure/volume relationship during dobutamine stress echocardiography in transplanted heart: comparison with quality of life and coronary anatomy

25 consecutive patients underwent DSE within 24 hours after MSCT coronary angiogram and then they underwent CA. The HRQoL questionnaire was administered to the patients in the settings of DSE. They were followed-up for 6 months.DSE has a sensitivity in detecting CAV of 67%, specificity of 95%, positive predictive value of 67% and negative predictive value of 95%; DSE with ESPVR has a sensitivity of 100%, specificity of 95%, positive predictive value of 75%, negative predictive value of 100%; MSCT has a sensitivity of 100%; specificity of 82%; positive predictive value of 43%; negative predictive value of 100%. Htx recipients with a flat-biphasic ESPVR, although asymptomatic, perceived a worst HRQoL compared with the up-sloping ESPVR population, and this is statistically significant for the general health (p 0.0004), the vitality (p 0.0013) and the mental health (p 0.021) SF-36 subscale.Evaluation with DSE and ESPVR is accurate in the clinical control of heart transplant recipients reserving invasive evaluation only for patients with abnormal contractility indexes.Cardiac allograft vasculopathy (CAV) is a major late complication in cardiac transplant recipients. This disease is insidious and usually gives no clues until heart failure, myocardial infarction, or death occurs [1-4]. Routine evaluation with coronary angiography and/or intravascular ultrasound are not a reasonable approach because invasive and potentially harmful, expensive, and sometimes inaccurate. Less invasive methods in identifying patients at increased risk of CAV haves been tested in recent studies [5-8]; Multislice Computed Tomography (MSCT) and dobutamine stress echocardiography (DSE) have shown to be accurate diagnostic techniques for this harmful condition [9,10].In recent years, Bombardini and co-workers [11-13] demonstrated that the left ventricular (LV) end-systolic pressure-volume relationship (ESPVR) was a prognostically useful noninvasive index of global contractility, associated with adv