Real Time Myocardial Perfusion Echocardiography for Coronary Allograft Vasculopathy

Heart transplant recipients are susceptible to developing a unique disease that causes
blockages in the arteries of the transplanted heart (coronary arteries) called Coronary
Allograft Vasculopathy (CAV). Because CAV often progresses without symptoms, transplant
recipients undergo regular surveillance testing so that CAV can be detected and treatment can
be offered before significant damage to the transplanted heart occurs. Current tests used to
detect CAV are either invasive (with risk of complications) or may not be able to detect CAV
in its early stages. Myocardial contrast perfusion echocardiography is a safe non-invasive
diagnostic test that may be well suited for detecting CAV, however has not been well studied
in heart transplant recipients. This study examines the ability of myocardial contrast
perfusion echocardiography to detect CAV in adult and pediatric heart transplant recipients,
and compare those results to current standard testing strategies such as Invasive Coronary
Angiography (ICA) and standard stress echocardiography. This will help determine whether
myocardial contrast perfusion echocardiography is a better test for regular surveillance of
CAV in adult and pediatric transplant recipients.

Inclusion:

- Cardiac transplant recipients (> or equal to 10 months post transplant)

- Clinically followed at Mayo Clinic, Rochester Minnesota

Exclusion:

- Standard contraindications to the use of ultrasound contrast and pharmacologic stress

- Recent (< 3 months) hospitalization for heart failure, acute coronary syndrome or
allograft rejection

- Multi-organ transplant Known or suspected right-to-left, bi-directional, or transient
right-to-left cardiac shunts

- Hypersensitivity to perflutren