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Updated: Jun 26, 2026
Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique
Published on: October 12, 2014
Cardiac allograft vasculopathy in heart transplanted recipients: The multivessel study
Niels Møller Jensen1,2, Tor Skibsted Clemmensen1, Kamilla Pernille Bjerre1,2
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Insights
Cardiac allograft vasculopathy (CAV) unequally affects coronary arteries after heart transplant. The left descending artery shows the most significant changes and best predicts CAV progression using optical coherence tomography (OCT).
Area of Science:
- Cardiology
- Transplantation Immunology
- Medical Imaging
Background:
- Cardiac allograft vasculopathy (CAV) is a common complication after heart transplantation.
- Understanding CAV's impact on different coronary arteries is crucial for patient outcomes.
Purpose of the Study:
- To assess if CAV causes differential vascular remodeling in major coronary arteries using quantitative optical coherence tomography (OCT).
- To explore the prognostic value of OCT-derived measurements from individual coronary arteries for CAV progression.
Main Methods:
- Sixty-four heart transplant recipients underwent 3-vessel OCT and coronary angiography.
- OCT data were categorized by CAV severity (none, mild, moderate, severe).
- Disease progression was tracked until July 2022.
Main Results:
- Significant differences in lumen/intima and intima/media ratios were observed in severe CAV across coronary arteries.
- The left descending artery (LAD) exhibited smaller lumen and larger intima areas compared to other arteries in CAV groups.
- LAD-derived intima/media and lumen/intima ratios were the strongest predictors of CAV progression, outperforming predictions from all three arteries.
Conclusions:
- CAV differentially impacts vascular remodeling in major coronary arteries, with the LAD being most affected.
- OCT measurements from the LAD provide superior prognostic information for CAV progression compared to other coronary arteries.
Background:
Cardiac allograft vasculopathy (CAV) is a prevailing complication following heart transplantation. We aimed to investigate if CAV causes equal vascular remodeling in the major coronary arteries using quantitative optical coherence tomography (OCT) and to explore the prognostic potential of OCT-derived measurements from each coronary artery.
Methods:
Sixty-four heart transplanted patients had a combined total of 114 full 3-vessel OCTs and coronary angiographies performed between 2013 and 2019. OCT pullbacks were categorized by angiographic CAV classification. Registration of disease progression was censored on July 1, 2022.
Results:
OCT recordings were classified as follows: no significant CAV, n = 73; mild CAV, n = 18; moderate CAV, n = 13; and severe CAV, n = 10. From intercoronary comparison of severe CAV, we found significant differences by both average lumen/intima ratio (p < 0.0001) and average intima/media ratio (p < 0.0001). The left descending artery (LAD) showed increasingly smaller luminal areas and larger intimal areas within CAV groups compared with the remaining coronary arteries. No differences were seen between major coronary arteries without significant CAV. LAD derived average intima/media ratio (hazard ratio (HR): 3.39; 95% confidence interval (CI): 1.33-8.63; p = 0.01) and average lumen/intima ratio (HR: 2.77; 95% CI: 1.09-7.05; p = 0.03) were the strongest predictors of CAV progression.LAD predictions were superior to predictions based on all 3 coronary arteries.
Conclusions:
LAD-derived OCT measurements were increasingly affected by CAV compared with the circumflex and right coronary artery. Average lumen/intima and intima/media ratios were the strongest predictors of CAV progression.
