Coronary microvascular dysfunction correlates with the new onset of cardiac allograft vasculopathy in heart transplant patients with normal coronary angiography

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
F TonaSabino Iliceto

Abstract

Coronary microvascular dysfunction is emerging as a strong predictor of outcome in heart transplantation (HT). We assessed the validity of microvascular dysfunction, defined by means of a reduced coronary flow reserve (CFR), as a factor associated with new onset epicardial cardiac allograft vasculopathy (CAV) or death. We studied 105 patients at 4 ± 1 years post-HT with a normal coronary angiography (CA). New onset CAV was assessed by CA. CFR was assessed in the left anterior descending (LAD) coronary artery by transthoracic Doppler echocardiography and calculated as the ratio of hyperaemic to basal blood flow velocity. A CFR ≤ 2.5 was considered abnormal. Epicardial CAV onset or death was assessed during a follow-up of 10 years. New onset CAV was diagnosed in 30 patients (28.6%) (Group A), and the CA was normal in the remaining 75 patients (71.4%) (Group B). Group A had reduced CFR compared with group B (2.4 ± 0.6 vs. 3.2 ± 0.7, p < 0.0001). A CFR ≤ 2.5 was independently associated with a higher probability of new onset CAV (p < 0.0001) and a higher probability of death, regardless of CAV onset (p < 0.01). Microvascular dysfunction is independently associated with the onset of epicardial CAV, and associated with a higher risk ...Continue Reading

References

Aug 7, 2002·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Andreas KönigVolker Klauss
May 19, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Alida L P CaforioGino Gerosa
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Apr 14, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F TonaS Iliceto
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Feb 23, 2007·The New England Journal of Medicine·Paolo G Camici, Filippo Crea
May 7, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Elena OstoSabino Iliceto
Jul 14, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Mandeep R MehraPatricia A Uber
Jul 21, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F TonaS Iliceto
Aug 31, 2012·Circulation. Heart Failure·François HaddadWilliam F Fearon
Mar 13, 2014·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Leyla Elif SadeHaldun Müderrisoğlu

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Citations

Dec 30, 2015·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Gregory A PayneDeepak Acharya
Apr 27, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Ole Geir SolbergLars Aaberge
Jul 2, 2016·Journal of the American College of Cardiology·Sharon ChihRob S B Beanlands
Jul 26, 2019·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·T S ClemmensenU B Knudsen
Aug 1, 2020·American Journal of Physiology. Heart and Circulatory Physiology·Gabrielle A DillonLacy M Alexander
Jan 19, 2021·Seminars in Nuclear Medicine·Tor Skibsted ClemmensenHans Eiskjær
Jun 22, 2021·Journal of Interventional Cardiology·Monika KodeboinaCarlos Collet
Nov 12, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Filippo CreaRiccardo Rinaldi

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