Madeleine Orban1, Sarah Ulrich2, Dominic Dischl3, Patrick von Samson-Himmelstjerna4, René Schramm4, Katharina Tippmann3, Ralph Hein-Rothweiler3, Anna Strüven3, Anja Lehner2, Daniel Braun3, Jörg Hausleiter5, Andre Jakob2, Marcus Fischer2, Christian Hagl6, Nikolaus Haas2, Steffen Massberg5, Julinda Mehilli5, Dalla Pozza Robert2. 1. Department of Cardiology, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany; Partner Site Munich Heart Alliance, German Centre for Cardiovascular Research (DZHK), Germany. Electronic address: Madeleine.Orban@med.uni-muenchen.de. 2. Department of Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany. 3. Department of Cardiology, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany. 4. Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany. 5. Department of Cardiology, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany; Partner Site Munich Heart Alliance, German Centre for Cardiovascular Research (DZHK), Germany. 6. Department of Heart Surgery, Ludwig-Maximilians-University, Klinikum Großhadern, Munich, Germany; Partner Site Munich Heart Alliance, German Centre for Cardiovascular Research (DZHK), Germany.
Abstract
BACKGROUND: Intracoronary imaging enables an early detection of intimal changes. To what extend the development of absolute and relative intimal hyperplasia in intracoronary imaging differs depending on age and post-transplant time is not known. METHODS: Aim of our retrospective study was to compare findings between 24 pediatric (cohort P) and 21 adult HTx patients (cohort A) using optical coherence tomography (OCT) at corresponding post-transplant intervals (≤5 years: P1 (n = 11) and A1 (n = 10); >5 and ≤ 10 years: P2 (n = 13) and A2 (n = 11),. Coronary intima thickness (IT), media thickness (MT) and intima to media ratio (I/M) were assessed per quadrant. Maximal IT >0.3 mm was considered absolute, I/M > 1 relative intimal hyperplasia. RESULTS: Compared to A1, I/M was significantly higher in P1 (maximal I/M: P1: 5.41 [2.81-13.39] vs. A1: 2.30 [1.55-3.62], p = 0.005), whereas absolute IT values were comparable. In contrast, I/M was comparable between P2 and A2, but absolute IT were significantly higher in A2 (maximal IT: P2: 0.16 mm [0.11-0.25] vs. A2: 0.40 mm [0.30-0.71], p < 0.001). A2 presented with higher absolute IT (maximal: A1: 0.16 mm [0.12-0.44] vs. A2: 0.40 mm [0.30-0.71], p = 0.02) and I/M (maximal I/M A1: 2.30 [1.55-3.62] vs. A2: 3.79 [3.01-5.62], p = 0.04). CONCLUSION: Our results suggest an age- and time-dependent difference in the prevalence of absolute and relative intimal hyperplasia in OCT, with an early peak in children and a progressive increase in adults.
BACKGROUND: Intracoronary imaging enables an early detection of intimal changes. To what extend the development of absolute and relative intimal hyperplasia in intracoronary imaging differs depending on age and post-transplant time is not known. METHODS: Aim of our retrospective study was to compare findings between 24 pediatric (cohort P) and 21 adult HTx patients (cohort A) using optical coherence tomography (OCT) at corresponding post-transplant intervals (≤5 years: P1 (n = 11) and A1 (n = 10); >5 and ≤ 10 years: P2 (n = 13) and A2 (n = 11),. Coronary intima thickness (IT), media thickness (MT) and intima to media ratio (I/M) were assessed per quadrant. Maximal IT >0.3 mm was considered absolute, I/M > 1 relative intimal hyperplasia. RESULTS: Compared to A1, I/M was significantly higher in P1 (maximal I/M: P1: 5.41 [2.81-13.39] vs. A1: 2.30 [1.55-3.62], p = 0.005), whereas absolute IT values were comparable. In contrast, I/M was comparable between P2 and A2, but absolute IT were significantly higher in A2 (maximal IT: P2: 0.16 mm [0.11-0.25] vs. A2: 0.40 mm [0.30-0.71], p < 0.001). A2 presented with higher absolute IT (maximal: A1: 0.16 mm [0.12-0.44] vs. A2: 0.40 mm [0.30-0.71], p = 0.02) and I/M (maximal I/M A1: 2.30 [1.55-3.62] vs. A2: 3.79 [3.01-5.62], p = 0.04). CONCLUSION: Our results suggest an age- and time-dependent difference in the prevalence of absolute and relative intimal hyperplasia in OCT, with an early peak in children and a progressive increase in adults.
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