Abstract 11675: Influence of Donor-Transmitted Lesions on Vessel Remodeling and Plaque Progression in Coronary Artery After Heart Transplant Recipients: Serial Three-Dimensional Intravascular Ultrasound Analysis
Introduction: The association between the presence of donor-transmitted lesions (DL) and the progression of cardiac allograft vasculopathy (CAV) including coronary vessel remodeling has been still controversial. The purpose of present study was to elucidate the influence of DL on coronary artery morphology after heart transplantation (HTx).
Methods: Serial three-dimensional intravascular ultrasounds (3D-IVUS) analyses were performed in 50 HTx recipients at 9.0±3.6 weeks after HTx and annually thereafter for 5 years. Sites at baseline with maximum intimal thickening≧0.5 mm of anterior descending artery (LAD) were defined as DL. Significant functional narrowing by IVUS was defined as %plaque area (plaque area/vessel area) >40%. A mixed-model repeated-measures analysis was used.
Results: DL was present in 54.0% in all recipients. In the first year after HTx, plaque volume significantly increased from 2.04±1.22 to 2.59±1.54 mm3/mm (p<0.01) in recipients with DL. Furthermore, the increase of plaque volume during 1 year after HTx was significantly higher in recipients with DL (0.62±0.85 vs 0.16±0.50 mm3/mm, p=0.048). Vessel volume in recipients with DL were greater than without DL at 1 year after HTx (12.84±3.15 vs 10.84±2.78 mm3/mm, p=0.024). Thereafter, the vessel volume decreased in both groups during 5 years. Consequently, the incidence of functional narrowing up to 5 years was higher in recipients with DL than in without DL (66.7% vs 30.4%, p=0.001). Cox proportional hazard model showed that the presence of DL increased the risk of functional narrowing (hazard ratio:HR3.38, 95% confidence interval 1.35-8.45) after adjusting for donor age, donor sex and the level of high density lipoprotein at 1 year.
Conclusions: The presence of DL influenced not only the increase of plaque volume during the first year but also the vessel remodeling during 5 years. Recipients with DL have a higher incidence of significant functional narrowing by IVUS.
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. T. Kobayashi: None. Y. Nakao: None. M. Nakai: None. M. Takegami: None. A. Higashiyama: None. M. Watanabe: None. Y. Kokubo: None. H. Hata: None. T. Fujita: None. Y. Miyamoto: None. T. Nakatani: None.
- © 2014 by American Heart Association, Inc.