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(Circulation. 2001;104:2874.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Regression of a Donor Atheroma After Cardiac Transplantation

Serial Observations With Intravascular Ultrasound

Hiroshi Tsutsui, MD; Paul Schoenhagen, MD; Jon D. Klingensmith, MS; D. Geoffrey Vince, PhD; Steven E. Nissen, MD; E. Murat Tuzcu, MD

From the Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio.

Correspondence to E. Murat Tuzcu, MD, Department of Cardiology F25, the Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195. E-mail tuzcue{at}ccf.org

A 42-year-old man received a cardiac transplantation in October 1995 for dilated cardiomyopathy. He had no history of hyperlipidemia or coronary artery disease. The heart donor was a 41-year-old woman with a history of hypertension. The first intravascular ultrasound (IVUS) study was obtained 14 days after cardiac transplantation, and the last follow-up examination was performed 5 years later. Figures 1 and 2 show a hypoechoic atheroma in the proximal left anterior descending artery that was transmitted from the donor. At this site, serial IVUS imaging demonstrates apparent spontaneous regression of the donor atheroma (Figures 1 and 2). The presence of prominent perivascular landmarks confirms the identical location of IVUS images from both time points. Of note, the regression in atheroma volume is accompanied by new calcification, a process that is thought to represent plaque stabilization. These changes show a dramatic regression in a transmitted donor atheroma after cardiac transplantation and suggest the potential for antiatherosclerotic therapy to regress atherosclerosis in the natural course of native coronary artery disease.

View larger version (91K): [in this window] [in a new window]   Figure 1. Reconstructed 3D IVUS images and IVUS still images. The blue lines on the 3D images show the lumen area in each slice. Baseline study is shown on left; images 5 years after transplantation are shown on right.

View larger version (113K): [in this window] [in a new window]   Figure 2. Sequential IVUS still images matched for the two IVUS examinations. Baseline study is shown on top; images 5 years after transplantation are shown on bottom.

Acknowledgments

Dr Tsutsui was partially supported by a research grant from the Japanese Association for the Advancement of Medical Equipment, which is affiliated with the Ministry of Health and Welfare of Japan.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke‘s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke‘s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tsutsui, H. Articles by Tuzcu, E. M. Search for Related Content PubMed PubMed Citation Articles by Tsutsui, H. Articles by Tuzcu, E. M. Related Collections Cardiovascular imaging agents/Techniques Pathophysiology Imaging Coronary imaging: angiography/ultrasound/Doppler/CC CV surgery: transplantation, ventricular assistance, cardiomyopathy