Abstract 11585: Is Brachial Flow-Mediated Dilation the Predictor of Development of Cardiac Allograft Vasculopathy in Recipients With Heart Transplantation?
Introduction: Cardiac allograft vasculopathy (CAV) is one of the main causes of death in heart transplant (HTx) recipients. Usefulness of FMD for predictor of CAV progression is not clear.
Methods: Forty three HTx recipients were included and they underwent measurement of FMD at mean 4.8 years after HTx. All recipients were performed three-dimensional intravascular ultrasounds (3D-IVUS) analysis just after HTx (First; mean 0.3 ± 0.5 year after HTx) and at the time (Last; mean 4.8 ± 3.7 year after HTx) when FMD was performed. We defined the impairment of endothelial function (I-EF) as brachial artery FMD<6.0%. The median of plaque volume index (PVI, plaque volume/measured vessel length) at first IVUS was 0.92 mm3/mm. The subjects were sub classified according to PVI at first IVUS, the greater PVI group (≧0.92 mm3/mm) and the less PVI group (<0.92 mm3/mm).
Results: Most of HTx recipients were diagnosed as non-ischemic heart disease (95.3%). 16 recipients had impairment of endothelial function (I-EF group). At first and last IVUS, PVI were significantly greater in the I-EF group. Endothelial function was significantly impaired in 10 recipients (45.5%) in the greater PVI group and 6 (28.6%) in the less PVI group. In the greater PVI group, recipients with I-EF had a greater PVI at last IVUS in the comparison with recipients without I-EF (2.23±0.89 vs 3.87±1.84 mm3/mm, p=0.013). In the less PVI group, there were no significant difference in PVI at last IVUS between with and without I-EF (0.81±0.49 vs 1.50±1.25 mm3/mm/year, p=0.075). After multivariate adjustment for the greater PVI(≧0.92 mm3/mm) at baseline, time of last IVUS year since HTx and the presence of I-EF, the presence of I-EF was independently associated with PVI at last IVUS (β coefficient=1.16, 95%CI; 0.42 to 1.90, p=0.003).
Conclusions: Impairment of endothelial function was associated with the plaque progression in HTx recipients.
Author Disclosures: T. Watanabe: None. O. Seguchi: None. K. Nishimura: None. M. Yanase: None. T. Sato: None. H. Sunami: None. S. Nakajima: None. E. Hisamatsu: None. T. Sato: None. K. Kuroda: None. Y. Nakao: None. M. Nakai: None. M. Takegami: None. H. Hata: None. T. Fujita: None. Y. Miyamoto: None. T. Nakatani: None. T. Kobayashi: None. A. Higashiyama: None. M. Watanabe: None. Y. Kokubo: None.
- © 2014 by American Heart Association, Inc.