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Coronary artery intimal thickening and ventricular dynamics in pediatric heart transplant recipients

Anita T Cote1,2, Martin Hosking3, Christine Voss1,3

  • 1Department of Pediatrics, University of British Columbia & British Columbia Children's Hospital Research Institute, Vancouver, Canada.

Congenital Heart Disease
|September 6, 2018
PubMed

Insights

Coronary artery intimal thickening in pediatric heart transplant patients is linked to declining ventricular function. Optical coherence tomography (OCT) can identify these changes, aiding in understanding cardiac allograft vasculopathy (CAV).

Area of Science:

  • Cardiology
  • Transplantation immunology
  • Medical imaging

Background:

  • Pediatric heart transplant recipients face risks of cardiac allograft vasculopathy (CAV) and diastolic dysfunction.
  • Coronary artery intimal thickening, a hallmark of CAV, can be detected using optical coherence tomography (OCT).
  • The mechanistic link between CAV progression and declining ventricular function requires further investigation.

Purpose of the Study:

  • To assess coronary artery intimal thickening in pediatric heart transplant recipients using OCT.
  • To evaluate left ventricular (LV) strain and function in these patients.
  • To investigate the relationship between intimal thickening and ventricular dysfunction.

Main Methods:

  • Analysis of OCT images for coronary intima and media thickness and cross-sectional area (CSA) in 17 children.
  • Speckle tracking imaging (STI) of the LV to determine longitudinal strain and strain rate.
  • Standard echocardiographic measures were also obtained.

Main Results:

  • Longitudinal diastolic strain rate showed significant associations with intima thickness and CSA (r = -.497 to -.614, P = .009 to .047).
  • Intima thickness, intima/media, and intima/lumen ratios correlated with stroke volume index (Std. β = -0.487 to -0.488, P = .022 to .023).
  • These findings indicate a correlation between coronary intimal thickening and impaired ventricular function.

Conclusions:

  • Coronary artery intimal thickening is mechanistically linked to ventricular function changes post-cardiac transplantation.
  • OCT is a valuable tool for detecting early CAV changes.
  • Further research is warranted to explore therapeutic strategies targeting intimal thickening to preserve ventricular function.
Abstract

Keywords:
coronary arteryheart transplantationleft ventricular strain

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