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Progression of cardiac allograft vasculopathy assessed by serial three-vessel quantitative coronary angiography

Christian Zanchin1, Kyohei Yamaji1, Carolin Rogge1

  • 1Department of Cardiology, Bern University Hospital, Bern, Switzerland.

Plos One
|August 28, 2018
PubMed

Insights

Cardiac allograft vasculopathy (CAV) progresses significantly after heart transplantation, even in patients without early visual signs. Quantitative coronary angiography (QCA) confirms long-term CAV progression, though it may not predict it beyond one year.

Area of Science:

  • Cardiology
  • Transplantation Immunology
  • Vascular Biology

Background:

  • Cardiac allograft vasculopathy (CAV) is a major long-term complication after heart transplantation.
  • Assessing CAV progression is crucial for patient management and outcomes.

Purpose of the Study:

  • To evaluate the short- and long-term progression of CAV using serial 3-vessel quantitative coronary angiography (QCA).

Main Methods:

  • Serial 3-vessel QCA was performed at baseline, 1-year, and long-term follow-up (8.5±3.7 years) post-heart transplantation.
  • Changes in minimal lumen diameter (MLD) and percent diameter stenosis (%DS) were analyzed in matched segments.
  • Patients were classified using the ISHLT-CAV criteria (ISHLT-CAV0 vs. ISHLT-CAV1-3).

Main Results:

  • MLD significantly decreased from 1-year to long-term follow-up (Δ-0.08mm/year, P<0.001).
  • %DS significantly increased from baseline to 1-year (Δ+0.96%/year, P=0.041) and from 1-year to long-term follow-up (Δ+0.61%/year, P<0.001).
  • CAV progression occurred similarly in ISHLT-CAV0 and ISHLT-CAV1-3 groups between baseline and long-term follow-up.

Conclusions:

  • QCA confirms CAV progression beyond one year post-transplant.
  • CAV progresses to a similar extent in patients with and without early visual signs of CAV.
  • QCA may not be predictive of CAV beyond the first year.
Abstract

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