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Relationship between markers of plaque vulnerability in optical coherence tomography and atherosclerotic progression in adult patients with heart transplantation
- Source :
- The Journal of Heart and Lung Transplantation. 36:185-192
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease, and optical coherence tomography (OCT) provides detailed microstructural information. The current study was designed to test the hypothesis that markers of plaque vulnerability derived from OCT could predict CAV progression after heart transplantation (HTx).In 34 consecutive patients (median 3.1 years from HTx), intravascular ultrasound (IVUS) and OCT were performed in the left anterior descending artery (LAD) during routine annual coronary angiography. The presence of vulnerability markers, such as lipid pools, thin-cap fibroatheroma, macrophages and microchannels, was assessed in 100 consecutive frames of OCT in 20-mm segments of proximal LAD. The total number of appearances of vulnerable markers was defined as the vulnerability score (VS). Plaque volume (PV) was measured in the same study segment using IVUS at baseline and at 1-year follow-up, and the association between the baseline VS and the subsequent change in percent PV (PV / vessel volume × 100 [%PV]) was evaluated.Follow-up IVUS study was conducted after 12.5 ± 1.3 months. The mean VS was 59.9 ± 44.6. Compared with the initial %PV, the follow-up %PV increased in the study segment (25.6 ± 13.7% to 31.8 ± 17.5%, p0.001). The correlations between baseline VS and Δ%PV were significant in the study segment (r = 0.757, p0.001). On multivariable analysis, only the VS correlated significantly with Δ%PV.Our results demonstrate that the markers of plaque vulnerability in OCT can predict the progression of CAV. Therefore, in patients with HTx, OCT may aid in determining prognosis and guiding therapy related to CAV.
- Subjects :
- Adult
Graft Rejection
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
medicine.disease_cause
Risk Assessment
Cohort Studies
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Optical coherence tomography
Internal medicine
Intravascular ultrasound
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Ultrasonography, Interventional
Aged
Heart transplantation
Transplantation
medicine.diagnostic_test
business.industry
Middle Aged
Allografts
medicine.disease
Vulnerable plaque
Plaque, Atherosclerotic
medicine.anatomical_structure
Disease Progression
cardiovascular system
Cardiology
Heart Transplantation
Female
Surgery
Radiology
Cardiology and Cardiovascular Medicine
business
Tomography, Optical Coherence
Follow-Up Studies
Cohort study
Artery
Subjects
Details
- ISSN :
- 10532498
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- The Journal of Heart and Lung Transplantation
- Accession number :
- edsair.doi.dedup.....74c964a0cc23c8982e372b918bd74347
- Full Text :
- https://doi.org/10.1016/j.healun.2016.06.004