Bo Zheng1, Akiko Maehara2, Gary S Mintz3, Tamim M Nazif4, Yarden Waksman4, Fuyu Qiu2, Luz Jaquez4, LeRoy E Rabbani4, Mark A Apfelbaum4, Ziad A Ali5, Kate Dalton4, Ke Xu3, Charles C Marboe4, Donna M Mancini4, Giora Weisz6. 1. NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA Peking University First Hospital, Beijing, China. 2. NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA. 3. Cardiovascular Research Foundation, New York, NY, USA. 4. NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA. 5. NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Icahn School of Medicine at Mount Sinai, New York, NY, USA. 6. NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA Department of Cardiology, Shaare Zedek Medical Center, 12 Shmuel (Hans) Beyth Street, Jerusalem 91031, Israel weiszg@szmc.org.il.
Abstract
AIMS: The aim was to compare cardiac allograft vasculopathy to native atherosclerosis by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS). METHODS AND RESULTS: Twenty-seven atherosclerotic (non-transplant) patients and 28 heart transplant recipients undergoing routine surveillance coronary angiography underwent NIRS-IVUS imaging of the left anterior descending coronary artery. In each proximal, middle, and distal coronary artery segment, the maxLCBI4mm [4-mm long segment with maximum lipid core burden index (LCBI)] and corresponding IVUS parameters were compared. MaxLCBI4mm was significantly greater among atherosclerotic patients than the transplant patients in both proximal and middle coronary artery segments, but not in the distal segment. There was a positive linear correlation between maxLCBI4mm and maximum plaque burden in both groups, but atherosclerotic patients demonstrated a smaller maxLCBI4mm than transplant recipients among segments with plaque burden <40%. Among segments with a maximum plaque burden ≥40%, native-atherosclerosis patients had a greater maxLCBI4mm compared with transplant patients (P = 0.015). Calcification was present in 72.9% of native atherosclerosis and 14.7% of transplant segments (P< 0.001). Among the 165 analysed segments, prevalence of lipid-rich plaque (LRP) with superficial attenuation (30.9 vs. 1.2%, P < 0.001) or calcified LRP (13.6 vs. 2.4%, P = 0.03) was significantly greater in native atherosclerosis compared with transplant patients. Conversely, the proportion of segments with non-LRP (46.4 vs. 11.1%, P < 0.001) was higher in transplant patients. CONCLUSION: NIRS-IVUS imaging demonstrated early and accelerated lipid accumulation with smaller plaque burden and less calcium in patients after heart transplant when compared with patients with native atherosclerosis. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The aim was to compare cardiac allograft vasculopathy to native atherosclerosis by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS). METHODS AND RESULTS: Twenty-seven atherosclerotic (non-transplant) patients and 28 heart transplant recipients undergoing routine surveillance coronary angiography underwent NIRS-IVUS imaging of the left anterior descending coronary artery. In each proximal, middle, and distal coronary artery segment, the maxLCBI4mm [4-mm long segment with maximum lipid core burden index (LCBI)] and corresponding IVUS parameters were compared. MaxLCBI4mm was significantly greater among atheroscleroticpatients than the transplant patients in both proximal and middle coronary artery segments, but not in the distal segment. There was a positive linear correlation between maxLCBI4mm and maximum plaque burden in both groups, but atheroscleroticpatients demonstrated a smaller maxLCBI4mm than transplant recipients among segments with plaque burden <40%. Among segments with a maximum plaque burden ≥40%, native-atherosclerosispatients had a greater maxLCBI4mm compared with transplant patients (P = 0.015). Calcification was present in 72.9% of native atherosclerosis and 14.7% of transplant segments (P< 0.001). Among the 165 analysed segments, prevalence of lipid-rich plaque (LRP) with superficial attenuation (30.9 vs. 1.2%, P < 0.001) or calcified LRP (13.6 vs. 2.4%, P = 0.03) was significantly greater in native atherosclerosis compared with transplant patients. Conversely, the proportion of segments with non-LRP (46.4 vs. 11.1%, P < 0.001) was higher in transplant patients. CONCLUSION: NIRS-IVUS imaging demonstrated early and accelerated lipid accumulation with smaller plaque burden and less calcium in patients after heart transplant when compared with patients with native atherosclerosis. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Ali Javaheri; Maria Molina; Payman Zamani; Amrith Rodrigues; Eric Novak; Susan Chambers; Patricia Stutman; Wilhelmina Maslanek; Mary Williams; Scott M Lilly; Peter Heeger; Mohamed H Sayegh; Anil Chandraker; David M Briscoe; Kevin P Daly; Randall Starling; David Ikle; Jason Christie; J Eduardo Rame; Lee R Goldberg; Jeffrey Billheimer; Daniel J Rader Journal: J Heart Lung Transplant Date: 2016-07-15 Impact factor: 10.247