Author + information
- Bo Zheng,
- Akiko Maehara,
- Gary Mintz,
- Tamim Nazif,
- Yarden Wachsman,
- Luz Jaquez,
- Leroy Rabbani,
- Mark Apfelbaum,
- Ziad Ali,
- Kate Dalton,
- Donna Mancini and
- Giora Weisz
Cardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality among transplant pts. We hypothesize that the distribution of lipid rich plaque (LRP) as evaluated with Near-Infrared Spectroscopy (NIRS) may be related to hitory of rejection severity.
We performed NIRS/IVUS at the time of routine surveillance coronary angiography. NIRS data was transformed into a probability of LRP; pixels with a probability of LRP >0.6 were divided by all viable pixels to generate the lipid-core burden index (LCBI). In each proximal, middle and distal coronary artery segment, the relationship between a history of cellular rejection and maxLCBI4mm (the 4-mm long segment with the maximum LCBI) along with corresponding maximum plaque burden site by IVUS were evaluated.
Of 38 consecutive heart transplant pts, 12 had history of at least one prior rejection event of International Society for Heart and Lung Transplantation (ISHLT) of 3A or above [High grade rejection (HGR)]. Compared to no/mild rejection, HGR pts had longer duration from heart transplantation (11.3±3.9 vs 5.0±4.1 years, P <0.001). The IVUS/NIRS findings were similar in the 2 groups in proximal and middle segments. In distal segment, HGR pts had greater plaque burden and relatively higher LCBI as compared to no/mild rejection.
History of HGR is associated with more significant CAV and increasing lipid burden in the distal. These findings may contribute to the understanding of the pathophysiology of CAV.
|High Grade rejection (N=12)||None/mild rejection (N=26)||p value|
|Entire vessel LCBI||62±76||29±47||0.11|
|Minimal lumen area, mm2||9.2±4.1||10.2±3.7||0.47|
|Minimal lumen area, mm2||6.6±3.9||7.8±3.2||0.33|
|Minimal lumen area, mm2||4.5±2.2||5.2±2.0||0.31|
Moderated Poster Contributions
Saturday, March 29, 2014, 4:15 p.m.-4:30 p.m.
Session Title: TCT@ACC-i2: The Interventional Learning Pathway Moderated Posters II
Abstract Category: 35. TCT@ACC-i2: IVUS and Intravascular Physiology
Presentation Number: 2114M-367C
- 2014 American College of Cardiology Foundation