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2017 ; 101
(6
): 1310-1319
Nephropedia Template TP
gab.com Text
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English Wikipedia
Donor-Transmitted Atherosclerosis Associated With Worsening Cardiac Allograft
Vasculopathy After Heart Transplantation: Serial Volumetric Intravascular
Ultrasound Analysis
#MMPMID27472091
Watanabe T
; Seguchi O
; Yanase M
; Fujita T
; Murata Y
; Sato T
; Sunami H
; Nakajima S
; Kataoka Y
; Nishimura K
; Hisamatsu E
; Kuroda K
; Okada N
; Hori Y
; Wada K
; Hata H
; Ishibashi-Ueda H
; Miyamoto Y
; Fukushima N
; Kobayashi J
; Nakatani T
Transplantation
2017[Jun]; 101
(6
): 1310-1319
PMID27472091
show ga
BACKGROUND: The influence of preexisting donor-transmitted atherosclerosis (DA)
on cardiac allograft vasculopathy (CAV) development remains unclear. METHODS: We
performed 3-dimensional intravascular ultrasound (3D-IVUS) analysis in 42 heart
transplantation (HTx) recipients at 2.1 ± 0.9 months (baseline) and 12.2 ± 0.4
months post-HTx, as well as consecutive 3D-IVUS analyses up to 3 years post-HTx
in 35 of the 42 recipients. Donor-transmitted atherosclerosis was defined as a
maximal intimal thickness of 0.5 mm or greater at baseline. Changes in volumetric
IVUS parameters were compared in recipients with (DA group) and without DA
(DA-free group) at baseline, 1 year, and 3 years post-HTx. RESULTS:
Donor-transmitted atherosclerosis was observed in 57.1% of 42 recipients. The DA
group exhibited a significantly greater increase in plaque volume at 1 year
post-HTx (P < 0.001), leading to increased percent plaque volume (plaque
volume/vessel volume, [%]) (P < 0.001) and decreased luminal volume (P = 0.021).
Donor-transmitted atherosclerosis was independently associated with a greater
increase in percent plaque volume during the first post-HTx year (P = 0.011).
From 1 to 3 years post-HTx, the DA group underwent continuous reduction in
luminal volume (P = 0.022). These changes resulted in a higher incidence of
angiographic CAV at 3 years post-HTx in the DA group (58.8% vs 5.6%, P = 0.002).
CONCLUSIONS: This volumetric IVUS study suggests that DA correlates with the
worsening change in CAV several years post-HTx. Donor-transmitted atherosclerosis
recipients may require more aggressive treatment to prevent subsequent CAV
progression.