Author + information
- Liang Dong,
- Ari T. Pollack,
- Nazif Tamim,
- Donna Mancini,
- Ulrich Jorde,
- Gary Mintz,
- Akiko Maehara and
- Giora Weisz
Cardiac allograft vasculopathy may result from ‘standard’ atherosclerosis and/or transplant related allograft changes with diffuse involvement.
At routine annual follow–up angiogram, 37 transplant pts underwent OCT imaging of coronary artery. % intimal area was calculated as intimal divided by external elastic membrane area. Plaque with attenuation was defined a plaque with a fast signal drop off presumably indicating lipidic plaque or macrophages.
Pt age at transplantation was 31±11 yrs and 31 (84%) were male. The reason for transplantation was coronary artery disease in 13 (35%), and the time from transplantation to OCT imaging was 6.1±4.5 yrs. Ten pts had a prior history of international Society for Heart and Lung Transplantation (ISHLT) 3A rejection. %intimal area was significantly greater in the distal, mid, and proximal segments in the rejection group compared to the non–rejection group along with an increase maximum intimal thickness and more frequent plaque with attenuation in the mid and distal, but not the proximal segments (Table).
Pts with an history of ISHLT rejection of at least 3A have increased coronary intimal thickness and area, and higher percentage of plaque with attenuation as compared to pts without prior rejection. Diffuse intimal thickening with lipidic plaque, especially at the mid and distal segment, may indicate allograft vasculopathy rather than standard atherosclerotic changes that occur in proximal segments.
|Rejection History Group (n=10)||No Rejection Group (n=27)||p-value|
|Lumen area (mm2)||5.2±2.6||6.6±3.9||0.32|
|%Intimal area (%)||27.4±5.1||12.9±9.3||0.002|
|Max intimal thickness (μm)||425±376||230±203||0.055|
|Plaque with attenuation||40% (4)||12% (3)||0.16|
|Lumen area (mm2)||7.1±0.9||8.3±3.0||0.31|
|Max intimal thickness (μm)||554±253||307±257||0.018|
|Plaque with attenuation||70% (7)||19% (5)||0.007|
|Lumen area (mm2)||10.7±4.4||12.7±4.1||0.24|
|%Intimal area (%)||24.2±9.3||15.6±10.4||0.040|
|Max intimal thickness (μm)||529±189||410±367||0.37|
|Plaque with attenuation||44% (4)||23% (5)||0.38|
West, Room 2004
Sunday, March 10, 2013, 8:45 a.m.–8:55 a.m.
Session Title: Intravascular Imaging and Physiologic Assessment
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2907–7
- 2013 American College of Cardiology Foundation