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Quantitative CT assessment identifies more heart transplanted patients with progressive coronary wall thickening than

Mihály Károlyi1, Márton Kolossváry1, Andrea Bartykowszki1

  • 1MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.

Journal of Cardiovascular Computed Tomography
|December 12, 2018
PubMed

Insights

Quantitative coronary CT angiography (CTA) reveals progressive coronary wall thickening in heart transplant (HTX) patients, primarily due to non-calcified components. This quantitative method detects early signs of cardiac allograft vasculopathy (CAV) more effectively than standard clinical reads.

Area of Science:

  • Cardiology
  • Radiology
  • Transplantation Medicine

Background:

  • Cardiac allograft vasculopathy (CAV) is a major cause of graft failure after heart transplantation (HTX).
  • Early detection of CAV is crucial for patient outcomes.
  • Coronary wall thickening is an indicator of CAV.

Purpose of the Study:

  • To compare quantitative coronary CT angiography (CTA) assessment with standard clinical reading for identifying progressive coronary wall thickening in HTX patients.
  • To evaluate the feasibility of quantitative coronary CTA for detecting early signs of CAV.

Main Methods:

  • 35 heart transplant recipients underwent coronary CTA at one and two years post-transplant.
  • Quantitative analysis of total vessel wall volume, including calcified and non-calcified components, was performed.
  • Comparison between quantitative CTA findings and standard clinical reads for detecting coronary wall thickening.

Main Results:

  • Total vessel wall volume significantly increased between one and two years post-HTX (p < 0.001).
  • Progression was mainly attributed to non-calcified components (high-, intermediate-, and low-attenuation).
  • Quantitative CTA identified significantly more patients with progressive coronary wall thickening compared to standard clinical read (22 vs. 11, p=0.01).

Conclusions:

  • Quantitative coronary CTA is a feasible method for assessing coronary wall thickening in HTX patients.
  • Progressive coronary wall thickening within two years post-HTX is primarily due to non-calcified lesions.
  • This thickening may represent an early indicator of CAV.
Abstract

Keywords:
Cardiac allograft vasculopathyCoronary CT angiographyCoronary artery diseaseCoronary vesselsHeart transplantation

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