Abstract
Objectives To assess coronary plaque composition by virtual histology intravascular ultrasound (VH-IVUS) analysis in young adult recipients and to correlate these findings with time from heart transplant (HTx) and long-term outcomes. Background Rapid progression of coronary allograft vasculopathy after heart transplantation is a powerful predictor of mortality and clinical events at long-term. Methods Forty consecutive young adult recipients transplanted during childhood undergoing VH-IVUS during coronary surveillance have been prospectively included in this study. According to the time interval from HTx to VH-IVUS assessment, our cohort was divided into two groups (group A: ≤5 years, n = 13; group B: >5 years, n = 27). Results Group B showed an higher percentage of necrotic core and dense calcium (12 ± 2 vs. 5 ± 1%, P = 0.04; 8.2 vs. 2.1%, P = 0.03; respectively). An "inflammatory plaque" (necrotic core and dense calcium ≥30%) was detected in 34.8% of patients in group B and in none among group A patients (P = 0.03). Patients in group B had a number of adverse clinical events significantly higher than group A patients (53.8 vs. 14.3%; HR 4.45; 95% CI 1.62-12.16; P = 0.029) at long-term follow-up (4.2 years). The multivariate regression analysis showed that age (HR 1.5; 95% CI 1.1-2.0; P = 0.007), time from HTx (HR 1.8; 95% CI 1.6-4.8; P = 0.02), and inflammatory plaque (HR 2.4; 95% CI 1.1-5.3; P = 0.03) were independent predictors of adverse clinical events. Conclusions This study supports the hypothesis that time-dependent differences in plaque composition, as assessed by VH-IVUS, occur after HTx in young adult recipients, probably determining an increased risk of long-term clinical events. © 2013 Wiley Periodicals, Inc.
| Original language | English |
|---|---|
| Pages (from-to) | 70-77 |
| Number of pages | 8 |
| Journal | Catheterization and Cardiovascular Interventions |
| Volume | 83 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2014 |
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Keywords
- coronary allograft vasculopathy
- heart transplantation
- virtual histology intravascular ultrasound
- young adult recipients
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Coronary plaque composition assessed by intravascular ultrasound virtual histology : Association with long-term clinical outcomes after heart transplantation in young adult recipients. / Tomai, Fabrizio; Adorisio, Rachele; De Luca, Leonardo; Pilati, Mara; Petrolini, Alessandro; Ghini, Anna S.; Parisi, Francesco; Pongiglione, Giacomo; Gagliardi, Maria Giulia.
In: Catheterization and Cardiovascular Interventions, Vol. 83, No. 1, 01.01.2014, p. 70-77.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Coronary plaque composition assessed by intravascular ultrasound virtual histology
T2 - Association with long-term clinical outcomes after heart transplantation in young adult recipients
AU - Tomai, Fabrizio
AU - Adorisio, Rachele
AU - De Luca, Leonardo
AU - Pilati, Mara
AU - Petrolini, Alessandro
AU - Ghini, Anna S.
AU - Parisi, Francesco
AU - Pongiglione, Giacomo
AU - Gagliardi, Maria Giulia
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Objectives To assess coronary plaque composition by virtual histology intravascular ultrasound (VH-IVUS) analysis in young adult recipients and to correlate these findings with time from heart transplant (HTx) and long-term outcomes. Background Rapid progression of coronary allograft vasculopathy after heart transplantation is a powerful predictor of mortality and clinical events at long-term. Methods Forty consecutive young adult recipients transplanted during childhood undergoing VH-IVUS during coronary surveillance have been prospectively included in this study. According to the time interval from HTx to VH-IVUS assessment, our cohort was divided into two groups (group A: ≤5 years, n = 13; group B: >5 years, n = 27). Results Group B showed an higher percentage of necrotic core and dense calcium (12 ± 2 vs. 5 ± 1%, P = 0.04; 8.2 vs. 2.1%, P = 0.03; respectively). An "inflammatory plaque" (necrotic core and dense calcium ≥30%) was detected in 34.8% of patients in group B and in none among group A patients (P = 0.03). Patients in group B had a number of adverse clinical events significantly higher than group A patients (53.8 vs. 14.3%; HR 4.45; 95% CI 1.62-12.16; P = 0.029) at long-term follow-up (4.2 years). The multivariate regression analysis showed that age (HR 1.5; 95% CI 1.1-2.0; P = 0.007), time from HTx (HR 1.8; 95% CI 1.6-4.8; P = 0.02), and inflammatory plaque (HR 2.4; 95% CI 1.1-5.3; P = 0.03) were independent predictors of adverse clinical events. Conclusions This study supports the hypothesis that time-dependent differences in plaque composition, as assessed by VH-IVUS, occur after HTx in young adult recipients, probably determining an increased risk of long-term clinical events. © 2013 Wiley Periodicals, Inc.
AB - Objectives To assess coronary plaque composition by virtual histology intravascular ultrasound (VH-IVUS) analysis in young adult recipients and to correlate these findings with time from heart transplant (HTx) and long-term outcomes. Background Rapid progression of coronary allograft vasculopathy after heart transplantation is a powerful predictor of mortality and clinical events at long-term. Methods Forty consecutive young adult recipients transplanted during childhood undergoing VH-IVUS during coronary surveillance have been prospectively included in this study. According to the time interval from HTx to VH-IVUS assessment, our cohort was divided into two groups (group A: ≤5 years, n = 13; group B: >5 years, n = 27). Results Group B showed an higher percentage of necrotic core and dense calcium (12 ± 2 vs. 5 ± 1%, P = 0.04; 8.2 vs. 2.1%, P = 0.03; respectively). An "inflammatory plaque" (necrotic core and dense calcium ≥30%) was detected in 34.8% of patients in group B and in none among group A patients (P = 0.03). Patients in group B had a number of adverse clinical events significantly higher than group A patients (53.8 vs. 14.3%; HR 4.45; 95% CI 1.62-12.16; P = 0.029) at long-term follow-up (4.2 years). The multivariate regression analysis showed that age (HR 1.5; 95% CI 1.1-2.0; P = 0.007), time from HTx (HR 1.8; 95% CI 1.6-4.8; P = 0.02), and inflammatory plaque (HR 2.4; 95% CI 1.1-5.3; P = 0.03) were independent predictors of adverse clinical events. Conclusions This study supports the hypothesis that time-dependent differences in plaque composition, as assessed by VH-IVUS, occur after HTx in young adult recipients, probably determining an increased risk of long-term clinical events. © 2013 Wiley Periodicals, Inc.
KW - coronary allograft vasculopathy
KW - heart transplantation
KW - virtual histology intravascular ultrasound
KW - young adult recipients
UR - http://www.scopus.com/inward/record.url?scp=84890459458&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890459458&partnerID=8YFLogxK
U2 - 10.1002/ccd.25054
DO - 10.1002/ccd.25054
M3 - Article
VL - 83
SP - 70
EP - 77
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 1
ER -