Optical coherence tomography and intravascular ultrasound evaluation of cardiac allograft vasculopathy with and without intimal neovascularization

Ichibori, Yasuhiro; Ohtani, Tomohito; Nakatani, Daisaku; Tachibana, Kunihide; Yamaguchi, Osamu; Toda, Köichi; Fukushima, Norihide; Sawa, Yoshiki; Komuro, Issei; Kotani, Jun–ichi; Sakata, Yasushi

doi:10.1093/ehjci/jev110

Cited by 18 publications

(16 citation statements)

References 32 publications

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“…In this analysis, we link intimal neovascularization observed by OCT to co-incident CAV, establishing an association between IN visualization and clinical outcomes. Importantly, we also provide further demonstration of IN associations noted in small series by other investigators [5][6][7].…”

Section: Discussionsupporting

confidence: 81%

“…Ichibori et al reported increased intimal neovascularization at greater than 1-year posttransplant, which corroborates our finding of a significant association of INs with increasing transplant age. We also similarly observed an association between increasing MIT and the presence of INs (p < 0.001) [6]. We did not observe a significant association between INs and recipient hyperlipidemia, diabetes or prior CMV infection, as described by other authors, but did note an association with recipient hypertension [6,8].…”

Section: Corroboration With Prior Seriessupporting

confidence: 87%

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Association of Intimal Neovessels Noted by Optical Coherence Tomography with Cardiac Allograft Vasculopathy

Chahal

Parikh

Yoo

et al. 2020

Cureus

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Background Cardiac allograft vasculopathy (CAV) is a leading cause of graft failure in cardiac transplant recipients. Progression of intimal thickening noted during routine surveillance intracoronary imaging is associated with the development of CAV. However, mechanisms of CAV development are poorly understood and targets for therapy modification remain elusive. We investigated the association of neovessels (INs) within the intima, noted by optical coherence tomography (OCT) during routine CAV surveillance imaging, with intimal thickening and coincident CAV. Methods Coronary angiography and OCT images of 45 consecutive cardiac transplant recipients undergoing surveillance coronary imaging were reviewed. The presence of INs, defined as dark, tubular or rotund intimal structures, measuring 50-200 µm in diameter, noted in at least three OCT frames, was quantified. CAV diagnosis was determined by utilizing the International Society of Heart and Lung Transplant classification system. Demographic and clinical data was obtained by chart review. Significant associations between the presence of INs and CAV, intimal thickening, and demographic features were evaluated.

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Section: Discussionsupporting

confidence: 81%

Section: Corroboration With Prior Seriessupporting

confidence: 87%

Association of Intimal Neovessels Noted by Optical Coherence Tomography with Cardiac Allograft Vasculopathy

Chahal

Parikh

Yoo

et al. 2020

Cureus

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“…Multilayer appearance was associated with increase in plaque volume, necrotic core volume, and dense calcium volume and was found to be a potential predictor of plaque progression. OCT imaging also revealed that coronary microchannels, which indicate intimal neovascularization, are a novel and relevant morphological marker of CAV progression . OCT imaging also confirmed typical features of CAV .…”

Section: Discussionmentioning

confidence: 73%

Coronary artery disease in heart transplantation: new concepts for an old disease

et al. 2018

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Cardiac allograft vasculopathy (CAV) remains one of the main long-term complications after heart transplantation. We performed a systematic review focused on articles published in the previous 6 years to reappraise the novel evidences supporting risk factors, pathology, prevention, and treatment of CAV. We identified a search string for a literature search on PubMed. We excluded articles specifically focused on diagnosis/biomarkers/imaging only or complications of other diseases. We included 98 studies out of our search. Forty-eight articles describe risk factors for CAV, 13 pathology, 24 prevention, and 13 treatment for CAV. While confirming known concepts, we found supportive evidence that CAV pathophysiology may vary according to the time post-transplant and the prevalence of metabolic versus immune-mediated risk factors. Selective revascularization of focal lesions in patients with CAV may result in some clinical benefit, but CAV prevention, rather than treatment, by controlling risk factors and by using targeted immunosuppressive therapies is the most evidence-based approach to reduce disease progression.

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“…Odhalení skutečné hlavní příčiny CAV si vyžádá prospektivní studie zaměřené na protilátky proti dárcovsky specifi ckému lidskému leukocytárnímu antigenu v oběhu [32,33], které budou současně používat nové zobrazovací metody, jako např. optickou koherenční tomografi i [34].…”

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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Optical coherence tomography and intravascular ultrasound evaluation of cardiac allograft vasculopathy with and without intimal neovascularization

Abstract: OCT-identified microchannels increased sharply within the first year and were correlated with intimal volume and coronary risks. This suggests that neovascularization may play an important role in the progression of cardiac allograft vasculopathy.

Cited by 18 publications

References 32 publications

Association of Intimal Neovessels Noted by Optical Coherence Tomography with Cardiac Allograft Vasculopathy

Association of Intimal Neovessels Noted by Optical Coherence Tomography with Cardiac Allograft Vasculopathy

Coronary artery disease in heart transplantation: new concepts for an old disease

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

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