Coronary flow reserve by transthoracic echocardiography predicts epicardial intimal thickening in cardiac allograft vasculopathy

F. Tona, E. Osto, G. Tarantini, A. Gambino, F. Cavallin, G. Feltrin, R. Montisci, A. L P Caforio, G. Gerosa, S. Iliceto

Research output: Contribution to journalArticle

Abstract

Cardiac allograft vasculopathy (CAV) is the leading cause of morbidity and mortality in heart transplantation (HT).We sought to investigate the role of coronary flow reserve (CFR) by contrast-enhanced transthoracic echocardiography (CE-TTE) in CAV diagnosis. CAV was defined as maximal intimal thickness (MIT) assessed by intravascular ultrasound (IVUS) ≥0.5 mm. CFR was assessed in the left anterior descending coronary artery in 22 HT recipients at 6 ± 4 years post- HT. CAV was diagnosed in 10 patients (group A), 12 had normal coronaries (group B). The mean MIT was 0.7 ± 0.1mm(range 0.03-1.8).MITwas higher in group A (1.16 ± 0.3 mm vs. 0.34 ± 0.07 mm, p <0.0001). CFR was 3.1 ± 0.8 in all patients and lower in group A (2.5 ± 0.6 vs. 3.7 ± 0.3, p <0.0001). CFR was inversely related with MIT (r=-0.774, p <0.0001). A cut point of ≤2.9, identified as optimal by receiver operating characteristics analysis was 100% specific and 80% sensitive (PPV = 100%, NPV = 89%, Accuracy = 91%). CFR assessment by CE-TTE is a novel noninvasive diagnostic tool in the detection of CAV defined as MIT ≥0.5 mm. CFR by CE-TTE may reduce the need for routine IVUS in HT.

Original languageEnglish
Pages (from-to)1668-1676
Number of pages9
JournalAmerican Journal of Transplantation
Volume10
Issue number7
DOIs
Publication statusPublished - Jul 2010

Keywords

  • Cardiac allograft vasculopathy
  • Coronary flow reserve
  • Diagnosis
  • Follow-up studies
  • Heart transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)
  • Medicine(all)

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    Tona, F., Osto, E., Tarantini, G., Gambino, A., Cavallin, F., Feltrin, G., Montisci, R., Caforio, A. L. P., Gerosa, G., & Iliceto, S. (2010). Coronary flow reserve by transthoracic echocardiography predicts epicardial intimal thickening in cardiac allograft vasculopathy. American Journal of Transplantation, 10(7), 1668-1676. https://doi.org/10.1111/j.1600-6143.2010.03160.x