OBJECTIVE: To characterise the severity and progression of cardiac allograft vascular disease (CAVD) in a large patient cohort, and to evaluate possible immunological and non-immunological risk factors for progression. DESIGN: A prospective observational study using intravascular ultrasound. SETTING: Two university hospitals. PATIENTS AND MAIN OUTCOME MEASURES: Changes in focal plaque, lumen, and total vessel area (worst site method) were assessed at baseline and after 12.1 (2.8) months (mean (SD)) of follow up in a cohort of 96 patients (79 male, 17 female; mean age 48.7 (9.6) years; time post-transplant 26.0 (32.4) months). RESULTS: Overall, the mean (SD) intimal index of worst sites increased by 6.7 (8.8)%. The increase in the first 12 months was 7.5 (9.4)%, v 5.9 (8.0)% after the first year (NS). Analysing immunological and non-immunological risk factors (age, underlying disease, sex, donor age, immunosuppression, cytomegalovirus, rejection episodes, cholesterol), low density lipoprotein (LDL) cholesterol was found to be the most important predictor of severe progression (as defined by an increase in intimal index of >/= 15% (p = 0.01). CONCLUSIONS: Progression of CAVD is characterised by a continuing increase in intimal hyperplasia, especially within the first year after heart transplantation. LDL cholesterol is an important predictor of major progression.
OBJECTIVE: To characterise the severity and progression of cardiac allograft vascular disease (CAVD) in a large patient cohort, and to evaluate possible immunological and non-immunological risk factors for progression. DESIGN: A prospective observational study using intravascular ultrasound. SETTING: Two university hospitals. PATIENTS AND MAIN OUTCOME MEASURES: Changes in focal plaque, lumen, and total vessel area (worst site method) were assessed at baseline and after 12.1 (2.8) months (mean (SD)) of follow up in a cohort of 96 patients (79 male, 17 female; mean age 48.7 (9.6) years; time post-transplant 26.0 (32.4) months). RESULTS: Overall, the mean (SD) intimal index of worst sites increased by 6.7 (8.8)%. The increase in the first 12 months was 7.5 (9.4)%, v 5.9 (8.0)% after the first year (NS). Analysing immunological and non-immunological risk factors (age, underlying disease, sex, donor age, immunosuppression, cytomegalovirus, rejection episodes, cholesterol), low density lipoprotein (LDL) cholesterol was found to be the most important predictor of severe progression (as defined by an increase in intimal index of >/= 15% (p = 0.01). CONCLUSIONS: Progression of CAVD is characterised by a continuing increase in intimal hyperplasia, especially within the first year after heart transplantation. LDL cholesterol is an important predictor of major progression.
Authors: R A Nishimura; W D Edwards; C A Warnes; G S Reeder; D R Holmes; A J Tajik; P G Yock Journal: J Am Coll Cardiol Date: 1990-07 Impact factor: 24.094
Authors: S E Nissen; J C Gurley; C L Grines; D C Booth; R McClure; M Berk; C Fischer; A N DeMaria Journal: Circulation Date: 1991-09 Impact factor: 29.690
Authors: F W Smart; C M Ballantyne; B Cocanougher; J A Farmer; M E Sekela; G P Noon; J B Young Journal: Am J Cardiol Date: 1991-02-01 Impact factor: 2.778
Authors: Bo Zheng; Akiko Maehara; Gary S Mintz; Tamim M Nazif; Yarden Waksman; Fuyu Qiu; Luz Jaquez; LeRoy E Rabbani; Mark A Apfelbaum; Ziad A Ali; Kate Dalton; Lei Song; Ke Xu; Charles C Marboe; Donna M Mancini; Giora Weisz Journal: Int J Cardiovasc Imaging Date: 2015-09-25 Impact factor: 2.357
Authors: Madeleine Orban; Dominic Dischl; Christoph Müller; Sarah Ulrich; Tobias Petzold; Konstantinos Rizas; Martin W Orban; Daniel Braun; Jörg Hausleiter; Christian Hagl; Julinda Mehilli; Steffen Massberg Journal: Transplant Direct Date: 2021-12-23