Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;35(2):e14167.
doi: 10.1111/ctr.14167. Epub 2020 Dec 6.

Intravascular ultrasound for cardiac allograft vasculopathy detection

Oscar A Mendiz  1 , Paul Gamboa  1 , María F Renedo  2   3 , Gustavo A Lev  2   3 , Liliana E Favaloro  2   3 , Alejandro M Bertolotti  2   3
Affiliations

Intravascular ultrasound for cardiac allograft vasculopathy detection

Oscar A Mendiz et al. Clin Transplant. 2021 Feb.

Abstract

Cardiac allograft vasculopathy (CAV) after heart transplantation is a fibro-proliferative process affecting coronary arteries of the graft in up to 46.8% of the cases during the first 10 years post-transplantation. It is one of the main causes of graft loss and death. Due to graft denervation, CAV causing ischemia is usually clinically silent until the disease is far advanced. In this study, we compared coronary angiography with intravascular ultrasound (IVUS) for CAV detection. OUTCOMES: A total of 114 patients with HTx who underwent coronary angiography and IVUS between March 2018 and March 2019 were included. Mean follow-up was 87 ± 61 month. Lesions documented by coronary angiography were found in only 27 (24%) of the 114 patients. IVUS revealed ISHLT CAV 0 in 87 patients (76.3%); ISHLT CAV1 in 15 (13,1%) and ISHLT CAV2 and CAV3 in 6 patients (5.2%) each. Among 328 IVUS images, maximum intimal thickness (MIT) >0.5 mm was obtained in 60 vessels (52%) with 24 patients having three-vessel and 19 two-vessel involvement. CONCLUSION: As an adjunct to conventional coronary angiography to detect angiographically silent CAV in heart transplant patients, IVUS is a reliable and safe technique with a low complication rate. Large multicenter studies are necessary to confirm these findings and the potential long-term clinical impact of early detection in clinically and angiographically silent phase.

Keywords: cardiac allograft vasculopathy; chronic rejection; heart transplantation; intravascular ultrasound; vascular graft disease.

PubMed Disclaimer

References

REFERENCES

    1. Khush KK, Cherikh WS, Chambers DC, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report - 2019; focus theme: Donor and recipient size match [published correction appears in J Heart Lung Transplant. 2020 Jan; 39(1):91]. J Heart Lung Transplant. 2019;38(10):1056-1066.
    1. Gao SZ, Alderman EL, Schroeder JS, Silverman J, Hunt S. Accelerated coronary vascular disease in the heart transplant patient: coronary arteriographic findings. J Am Coll Cardiol. 1988;12:334-340.
    1. Hoang K, Chen YD, Reaven G, et al. Diabetes and dyslipidemia. A new model for transplant coronary artery disease. Circulation. 1998;97:2160-2168.
    1. Costanzo MR, Dipchand A, Starling R, et al. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant. Elsevier Inc.; 2010; 29: 914-956.
    1. Mehra MR, Crespo-Leiro MG, Dipchand A, et al. International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy-2010. J Heart Lung Transplant. 2010;29:717-727.

MeSH terms