Progression of cardiac allograft vasculopathy assessed by serial three-vessel quantitative coronary angiography

The purpose of the present study was to assess the short- and long-term progression of cardiac allograft vasculopathy (CAV) using serial 3-vessel quantitative coronary angiography (QCA). CAV progression was assessed using serial 3-vessel QCA analysis at baseline, 1-year and long-term angiographic fo...

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Published in:PloS one 2018-08, Vol.13 (8), p.e0202950-e0202950
Main Authors: Zanchin, Christian, Yamaji, Kyohei, Rogge, Carolin, Lesche, Dorothea, Zanchin, Thomas, Ueki, Yasushi, Windecker, Stephan, Mohacsi, Paul, Räber, Lorenz, Sigurdardottir, Vilborg
Format: Article
Language:English
Subjects:
Adult
Allografts
Angiography
Atherosclerosis
Biology and Life Sciences
Calcium channels (voltage-gated)
Cardiac Imaging Techniques - methods
Cardiology
Cardiovascular disease
Continuity of Patient Care
Coronary angiography
Coronary Angiography - methods
Coronary heart disease
Coronary vessels
Cytomegalovirus
Development and progression
Disease Progression
Female
Graft Occlusion, Vascular - diagnostic imaging
Graft Occlusion, Vascular - etiology
Graft Rejection - etiology
Graft Rejection - prevention & control
Health aspects
Heart
Heart Diseases - surgery
Heart transplantation
Heart Transplantation - adverse effects
Humans
Immunosuppressive agents
Male
Medical imaging
Medicine and Health Sciences
Middle Aged
Mortality
Patient outcomes
Patients
Postoperative Complications - diagnostic imaging
Reduction
Research and Analysis Methods
Retrospective Studies
Risk Assessment
Risk factors
Segments
Stenosis
Stents
Studies
Transplantation
Transplants & implants
Ultrasonic imaging
Vascular diseases
Vascular Diseases - diagnostic imaging
Vascular Diseases - etiology
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cited_by cdi_FETCH-LOGICAL-c692t-a87881b5ecfd8f4976d5a52b54e160ff9d5236796b40312599cedeb68de765b03
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container_issue 8
container_start_page e0202950
container_title PloS one
container_volume 13
creator Zanchin, Christian
Yamaji, Kyohei
Rogge, Carolin
Lesche, Dorothea
Zanchin, Thomas
Ueki, Yasushi
Windecker, Stephan
Mohacsi, Paul
Räber, Lorenz
Sigurdardottir, Vilborg
description The purpose of the present study was to assess the short- and long-term progression of cardiac allograft vasculopathy (CAV) using serial 3-vessel quantitative coronary angiography (QCA). CAV progression was assessed using serial 3-vessel QCA analysis at baseline, 1-year and long-term angiographic follow-up (8.5±3.7 years) after heart transplantation. The change in minimal lumen diameter (MLD) and percent diameter stenosis (%DS) was serially assessed within matched segments. Patients were graded according to the ISHLT-CAV classification and grouped as ISHLT-CAV0 and ISHLT-CAV1-3. The primary endpoint was mean change in MLD and %DS. A total of 41 patients and 520 matched segments were available for serial 3-vessel QCA. Overall, MLD decreased non-significantly from baseline to 1-year follow-up and significantly from 1-year to the long-term angiographic follow-up (Δ-0.08mm/year [95%CI -0.11 to -0.05], P
doi_str_mv 10.1371/journal.pone.0202950
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CAV progression was assessed using serial 3-vessel QCA analysis at baseline, 1-year and long-term angiographic follow-up (8.5±3.7 years) after heart transplantation. The change in minimal lumen diameter (MLD) and percent diameter stenosis (%DS) was serially assessed within matched segments. Patients were graded according to the ISHLT-CAV classification and grouped as ISHLT-CAV0 and ISHLT-CAV1-3. The primary endpoint was mean change in MLD and %DS. A total of 41 patients and 520 matched segments were available for serial 3-vessel QCA. Overall, MLD decreased non-significantly from baseline to 1-year follow-up and significantly from 1-year to the long-term angiographic follow-up (Δ-0.08mm/year [95%CI -0.11 to -0.05], P&lt;0.001). %DS increased significantly from baseline to 1-year (Δ+0.96%/year [95%CI 0.04 to 1.88], P = 0.041) and from 1-year to long-term angiographic follow-up (Δ+0.61%/year [95%CI 0.33 to 0.88], P&lt;0.001). ISHLT-CAV1-3 at 1 year and at long-term angiographic follow-up was observed in 22% and 61%, respectively. Between baseline and long-term angiographic follow-up, a significant reduction in MLD was observed within both groups without a significant difference in the reduction between the two groups (ISHLT-CAV0: median -0.49mm [IQR -0.54 to -0.43] vs. ISHLT-CAV1-3: median -0.40mm [IQR -0.44 to -0.35], P = 0.4). 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CAV progression was assessed using serial 3-vessel QCA analysis at baseline, 1-year and long-term angiographic follow-up (8.5±3.7 years) after heart transplantation. The change in minimal lumen diameter (MLD) and percent diameter stenosis (%DS) was serially assessed within matched segments. Patients were graded according to the ISHLT-CAV classification and grouped as ISHLT-CAV0 and ISHLT-CAV1-3. The primary endpoint was mean change in MLD and %DS. A total of 41 patients and 520 matched segments were available for serial 3-vessel QCA. Overall, MLD decreased non-significantly from baseline to 1-year follow-up and significantly from 1-year to the long-term angiographic follow-up (Δ-0.08mm/year [95%CI -0.11 to -0.05], P&lt;0.001). %DS increased significantly from baseline to 1-year (Δ+0.96%/year [95%CI 0.04 to 1.88], P = 0.041) and from 1-year to long-term angiographic follow-up (Δ+0.61%/year [95%CI 0.33 to 0.88], P&lt;0.001). 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CAV progression was assessed using serial 3-vessel QCA analysis at baseline, 1-year and long-term angiographic follow-up (8.5±3.7 years) after heart transplantation. The change in minimal lumen diameter (MLD) and percent diameter stenosis (%DS) was serially assessed within matched segments. Patients were graded according to the ISHLT-CAV classification and grouped as ISHLT-CAV0 and ISHLT-CAV1-3. The primary endpoint was mean change in MLD and %DS. A total of 41 patients and 520 matched segments were available for serial 3-vessel QCA. Overall, MLD decreased non-significantly from baseline to 1-year follow-up and significantly from 1-year to the long-term angiographic follow-up (Δ-0.08mm/year [95%CI -0.11 to -0.05], P&lt;0.001). %DS increased significantly from baseline to 1-year (Δ+0.96%/year [95%CI 0.04 to 1.88], P = 0.041) and from 1-year to long-term angiographic follow-up (Δ+0.61%/year [95%CI 0.33 to 0.88], P&lt;0.001). ISHLT-CAV1-3 at 1 year and at long-term angiographic follow-up was observed in 22% and 61%, respectively. Between baseline and long-term angiographic follow-up, a significant reduction in MLD was observed within both groups without a significant difference in the reduction between the two groups (ISHLT-CAV0: median -0.49mm [IQR -0.54 to -0.43] vs. ISHLT-CAV1-3: median -0.40mm [IQR -0.44 to -0.35], P = 0.4). The current data suggest that QCA can't predict CAV beyond 1 year, but, QCA affirmed that CAV progresses to a similar extent in patients who do not develop visual CAV during long-term follow-up.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30148864</pmid><doi>10.1371/journal.pone.0202950</doi><tpages>e0202950</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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issn 1932-6203
1932-6203
language eng
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source PubMed (Medline); Publicly Available Content Database
subjects Adult
Allografts
Angiography
Atherosclerosis
Biology and Life Sciences
Calcium channels (voltage-gated)
Cardiac Imaging Techniques - methods
Cardiology
Cardiovascular disease
Continuity of Patient Care
Coronary angiography
Coronary Angiography - methods
Coronary heart disease
Coronary vessels
Cytomegalovirus
Development and progression
Disease Progression
Female
Graft Occlusion, Vascular - diagnostic imaging
Graft Occlusion, Vascular - etiology
Graft Rejection - etiology
Graft Rejection - prevention & control
Health aspects
Heart
Heart Diseases - surgery
Heart transplantation
Heart Transplantation - adverse effects
Humans
Immunosuppressive agents
Male
Medical imaging
Medicine and Health Sciences
Middle Aged
Mortality
Patient outcomes
Patients
Postoperative Complications - diagnostic imaging
Reduction
Research and Analysis Methods
Retrospective Studies
Risk Assessment
Risk factors
Segments
Stenosis
Stents
Studies
Transplantation
Transplants & implants
Ultrasonic imaging
Vascular diseases
Vascular Diseases - diagnostic imaging
Vascular Diseases - etiology
title Progression of cardiac allograft vasculopathy assessed by serial three-vessel quantitative coronary angiography
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