Cardiac allograft vasculopathy in heart transplanted recipients: The multivessel study

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