Is intravascular ultrasound better than quantitative coronary arteriography to assess cardiac allograft arteriopathy?

Lowry, Richard W.; Kleiman, Neal S.; Raizner, Albert E.; Young, James B.

doi:10.1002/ccd.1810310204

Cited by 11 publications

(5 citation statements)

References 12 publications

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“…We also validated our QCA measurements to those obtained by IVUS and they were not statistically different. This is in agreement to the findings of Lowry et al (15).…”

Section: Discussionsupporting

confidence: 94%

“…QCA has been found to be much more sensitive than conventional qualitative angiography in detecting CAV (13,14), and its results have been found to correlate closely with that of intravascular ultrasound (IVUS), both for the early and late follow-up of transplanted patients (15). We thus used QCA to measure the mean lumen diameter loss (MLDL) as a marker of CAV.…”

Section: Quantitative Coronary Angiographymentioning

confidence: 99%

See 1 more Smart Citation

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Bolad

Robinson

Webb

et al. 2006

American Journal of Transplantation

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Cardiac allograft vasculopathy (CAV) is a major cause of death more than 1 year after heart transplantation. We evaluated the role and possible predictive value of different etiological factors on development of CAV as diagnosed by quantitative coronary angiography (QCA). A total of 121 patients were studied with baseline QCA and 117 had a follow-up study at 1 year to assess the relationship of mean lumen diameter loss (MLDL) in main coronary arteries to immunological and non-immunological factors potentially affecting long-term survival. Out of them, 103 patients were males (85%), 114 (94%) patients were Caucasians and mean age was 48.5 ± 10 years. Univariate analysis showed that MLDL at 1 year was inversely related to echocardiographic fractional shortening (FS) measured within the first week after transplantation (p = 0.0098) and to intracranial hemorrhage as cause of donor death (p = 0.04) and was directly related to male donors (p = 0.0008), domino transplants (p = 0.037) and donor negative cytomegalovirus (CMV) status (p = 0.022). Multivariate analysis showed that initial FS (p = 0.006) and donor intracranial hemorrhage as a cause of death (p = 0.042) were inversely related to MLDL whereas donor male sex (p = 0.003) and prednisolone treatment throughout the first year (p = 0.012) were directly related. Thus, left ventricular systolic dysfunction early after heart transplantation was associated with subsequent development of CAV.

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“…We also validated our QCA measurements to those obtained by IVUS and they were not statistically different. This is in agreement to the findings of Lowry et al (15).…”

Section: Discussionsupporting

confidence: 94%

Section: Quantitative Coronary Angiographymentioning

confidence: 99%

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Bolad

Robinson

Webb

et al. 2006

American Journal of Transplantation

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“…9 The sensitivity of intravascular ultrasound in identifying early changes in the transplanted heart is well documented. 7,10 -13 The measurements derived from intravascular ultrasound images have been validated with morphometric 5,14 and angiographic [15][16][17] measurements.…”

mentioning

confidence: 99%

Development of Transplantation Vasculopathy and Progression of Donor-Transmitted Atherosclerosis

et al. 1998

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Background-Transplant coronary artery disease is a combination of atherosclerosis transmitted from the donor and new lesions of allograft vasculopathy. We sought to determine the morphological characteristics of allograft vasculopathy and differentiate it from donor-transmitted atherosclerosis with serial intravascular ultrasound. Methods and Results-Intravascular ultrasound examination was performed in 93 patients at 27.2Ϯ15.0 and 369.7Ϯ23.9 days after transplantation. The maximally and minimally diseased sites were selected in each segment as defined by Coronary Artery Surgery Study classification. For each matched site, maximal plaque thickness was measured. Lesions (maximum plaque thickness Ն0.5 mm) present at baseline examination were defined as donor lesions. On follow-up, lesions that developed at previously normal sites were defined as de novo lesions. The distribution and severity of donor and de novo lesions were similar in proximal, mid, and distal segments. The de novo lesions were less focal (43% vs 74%) and more circumferential (69% vs 45%) compared with the donor lesions, but there was significant morphological heterogeneity. Similar numbers of patients with and those without donor lesions developed de novo lesions. Moreover, progression of donor lesions was not associated with the presence or absence of de novo lesions. Conclusions-Differentiation between early allograft vasculopathy from conventional atherosclerosis by distribution and morphology of lesions alone is difficult. Serial intravascular ultrasound imaging with early baseline examination is necessary to make this distinction. This distinction is important because the progression of donor lesions and the development of de novo lesions are independent of each other. (Circulation. 1998;98:2672-2678.)

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“…lovaly s výsledky intravaskulárního ultrazvuku v časném i pozdním období sledování příjemců štěpu [26]. Proto jsme k měření zúžení průměrného průsvitu jako markeru CAV používali QCA.…”

Section: Diskuseunclassified

Early progression of cardiac allograft vasculopathy assessed by quantitative coronary angiography: A single centre prospective study

Maxian¹,

Kautzner²,

Málek³

et al. 2018

Cor Vasa

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Úvod: Nezbytnou součástí péče o pacienty po transplantaci srdce (heart transplantation, HTx) je časná diagnostika vaskulopatie štěpu (cardiac allograft vasculopathy, CAV), kterou lze zmírnit specifi ckými klinickými postupy. Materiál a metody: Do této prospektivní, observační, monocentrické studie jsme zařadili 48 po sobě následujících pacientů. Pomocí kvantitativní koronarografi e (quantitative coronary angiography, QCA) jsme sledovali časný rozvoj CAV v prvním a 12. měsíci po HTx. Kvantitativní koronarografi cká měření byla posuzována dvěma nezávislými hodnotiteli. Zkoumali jsme vztah mezi CAV a vybranými klinickými a sérologickými proměnnými. Výsledky: V průběhu 12 měsíců po HTx bylo zaznamenáno významné zúžení průměrného průsvitu (mean lumen diameter, MLD) ve všech hlavních větvích koronárních tepen. Hodnoty zúžení MLD byly následující: pravá koronární tepna (RCA) (3,52 mm 3,25 mm; p = 0,0008), ramus circumfl exus (3,68 mm 3,42 mm; p < 0,0001) a r. interventricular anterior (RIA) (3,95 mm 3,69 mm; p < 0,0001). Ve skupině pacientů bylo nalezeno 14 osob s rychlou progresí CAV (14/48, 29,2 %). Celková hodnota zúžení MLD ve všech jejich sledovaných tepnách během 12 měsíců po HTx dosáhla ≥ 10 %. Zvýšená srdeční frekvence ve 12. měsíci po HTx sice ukazovala na nižší věk dárce (p = 0,01), nebyla však spojena s rychlou progresí CAV. Nejvýznamnějším prediktorem rychlé progrese CAV byla zvýšená sérová koncentrace natriuretického peptidu typu B (BNP) časně po HTx (3. den po HTx; p = 0,04). Závěr: Významné zúžení MLD všech hlavních koronárních tepen bylo nalezeno již během prvního roku po HTx. Časné zvýšení sérových koncentrací BNP predikovalo rychlou progresi CAV. Předpoklad, že se na rozvoji CAV u příjemců srdečního štěpu podílí vyšší srdeční frekvence, nebyl potvrzen.

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Is intravascular ultrasound better than quantitative coronary arteriography to assess cardiac allograft arteriopathy?

Cited by 11 publications

References 12 publications

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Development of Transplantation Vasculopathy and Progression of Donor-Transmitted Atherosclerosis

Early progression of cardiac allograft vasculopathy assessed by quantitative coronary angiography: A single centre prospective study

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