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Coronary collateral function in the transplanted heart: propensity score matching with coronary artery disease

Tobias Rutz1, Steffen Gloekler, Stefano F de Marchi

  • 1Department of Cardiology, University Hospital Bern, CH-3010, Bern, Switzerland.

Heart (British Cardiac Society)
|January 29, 2011
PubMed

Insights

Heart transplant recipients have comparable coronary collateral flow to coronary artery disease patients. This suggests transplant vasculopathy does not impair the heart's natural bypass system.

Area of Science:

  • Cardiology
  • Transplant Medicine
  • Vascular Biology

Background:

  • Coronary collateral circulation's role in heart transplant recipients is understudied.
  • Transplant vasculopathy may affect microcirculation, potentially impacting collateral development.

Purpose of the Study:

  • To investigate and compare the functional coronary collateral circulation in heart transplant patients versus coronary artery disease (CAD) patients.
  • To test the hypothesis that heart transplant recipients have less developed coronary collateral circulation.

Main Methods:

  • Quantitative coronary pressure-derived collateral measurements (Collateral Flow Index - CFI) and intravascular ultrasound (IVUS) were performed on 40 heart transplant patients.
  • Propensity score matching was used to compare heart transplant patients with 1076 CAD patients from an institutional database, controlling for stenosis severity, heart rate, hypertension, and dyslipidemia.

Main Results:

  • Eighty percent of heart transplant patients exhibited transplant vasculopathy (intima thickness ≥ 0.5 mm) via IVUS.
  • After propensity score matching, no significant difference in CFI was observed between heart transplant patients (0.152 ± 0.102) and the matched CAD group (0.176 ± 0.096).
  • IVUS findings of transplant vasculopathy were not correlated with CFI in the heart transplant group.

Conclusions:

  • Heart transplant patients demonstrate a similar functional degree of coronary collateral flow when compared to a propensity score-matched group of CAD patients.
  • The findings indicate that transplant vasculopathy, despite its presence, does not significantly impair the functional capacity of coronary collateral circulation in heart transplant recipients.
Abstract

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