SPECT's Reduced Sensitivity in Liver Transplant Candidates: The Role of Hyperdynamic Circulation and Attenuated Vasodilator Reserve

In liver transplant candidates, hyperdynamic circulation and blunted vasodilator reserve substantially lower SPECT sensitivity for coronary artery disease vs the general population. Interpret SPECT cautiously; quantitative PET myocardial flow reserve may add prognostic informati…

• Hyperdynamic circulation and elevated resting myocardial blood flow impair relative perfusion imaging.
• Reported SPECT sensitivity for CAD is substantially lower than in the general population.
• Quantitative PET-derived myocardial flow reserve shows possible prognostic value but lacks validated transplant-specific thresholds.

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