Donor-transmitted atherosclerosis associated with worsening cardiac allograft vasculopathy after heart transplantation: Serial volumetric intravascular ultrasound analysis

Takuya Watanabe, Osamu Seguchi, Masanobu Yanase, Tomoyuki Fujita, Yoshihiro Murata, Takuma Sato, Haruki Sunami, Seiko Nakajima, Yu Kataoka, Kunihiro Nishimura, Eriko Hisamatsu, Kensuke Kuroda, Norihiro Okada, Yumiko Hori, Kyoichi Wada, Hiroki Hata, Hatsue Ishibashi-Ueda, Yoshihiro Miyamoto, Norihide Fukushima, Junjiro KobayashiTakeshi Nakatani

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Background. The influence of preexisting donor-transmitted atherosclerosis (DA) on cardiac allograft vasculopathy (CAV) development remains unclear.Methods.We performed 3-dimensional intravascular ultrasound (3D-IVUS) analysis in 42 heart transplantation (HTx) recipients at 2.1 ± 0.9 months (baseline) and 12.2 ± 0.4 months post-HTx, as well as consecutive 3D-IVUS analyses up to 3 years post-HTx in 35 of the 42 recipients. Donor-transmitted atherosclerosis was defined as a maximal intimal thickness of 0.5 mm or greater at baseline. Changes in volumetric IVUS parameters were compared in recipients with (DA group) and without DA (DA-free group) at baseline, 1 year, and 3 years post-HTx. Results. Donor-transmitted atherosclerosis was observed in 57.1% of 42 recipients. The DA group exhibited a significantly greater increase in plaque volume at 1 year post-HTx (P < 0.001), leading to increased percent plaque volume (plaque volume/vessel volume, [%]) (P < 0.001) and decreased luminal volume (P = 0.021). Donor-transmitted atherosclerosis was independently associated with a greater increase in percent plaque volume during the first post-HTx year (P = 0.011). From 1 to 3 years post-HTx, the DA group underwent continuous reduction in luminal volume (P = 0.022). These changes resulted in a higher incidence of angiographic CAV at 3 years post-HTx in the DA group (58.8% vs 5.6%, P = 0.002). Conclusions. This volumetric IVUS study suggests that DA correlates with the worsening change in CAV several years post-HTx. Donor-transmitted atherosclerosis recipients may require more aggressive treatment to prevent subsequent CAV progression.

Original languageEnglish
Pages (from-to)1310-1319
Number of pages10
JournalTransplantation
Volume101
Issue number6
DOIs
Publication statusPublished - 06-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Transplantation

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