Cardiac allograft vasculopathy assessed by intravascular ultrasonography and nonimmunologic risk factors

Escobar, Alvaro, Ventura, Hector O., Stapleton, Dwight D., Mehra, Mandeep R., Ramee, Stephen R., Collins, Tyrone J., Jain, Suresh P., Smart, Frank W. and White, Christopher J. (1994) Cardiac allograft vasculopathy assessed by intravascular ultrasonography and nonimmunologic risk factors. American Journal of Cardiology, 74 10: 1042-1046. doi:10.1016/0002-9149(94)90856-7

Author Escobar, Alvaro
Ventura, Hector O.
Stapleton, Dwight D.
Mehra, Mandeep R.
Ramee, Stephen R.
Collins, Tyrone J.
Jain, Suresh P.
Smart, Frank W.
White, Christopher J.
Title Cardiac allograft vasculopathy assessed by intravascular ultrasonography and nonimmunologic risk factors
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 1994-11
Sub-type Article (original research)
DOI 10.1016/0002-9149(94)90856-7
Volume 74
Issue 10
Start page 1042
End page 1046
Total pages 5
Place of publication Bridgewater, NJ, United States
Publisher Excerpta Medica
Language eng
Formatted abstract
The genesis of cardiac allograft vasculopathy has been linked to nonimmunologc endothellal injury. Studies evaluating the role of nonimmunologic risk factors have thus far been limited to anglographic assessment. Intravascular ultrasound can detect cardiac allograft vasculopathy before it becomes anglographically evident. To assess the influence of nonimmunologc risk factors in the development of cardiac allograft vasculopathy, we studied 101 consecutive cardiac transplant recipients who underwent intracoronary ultrasound imaging during routine, annual coronary angography. Based on the severity of intimal thickening, patients were divided into 2 groups: group 1 = minimal, mild, or moderate intimal thickness; and group 2 = severe intimal thickness. Cardiac transplant recipients with severe intimal thickness had higher levels of total cholesterol (267 ± 70 vs 227 ± 41 mg/dl, p = 0.0008), low-density lipoprotein cholesterol (187 ± 47 vs 139 ± 31 mg/dl, p = 0.0001), and trigycerides (237 ± 75 vs 182 ± 88 mg/dl, p = 0.0004), a higher percentage of weight gain (12 ± 4% vs 8 ± 5%, p = 0.0001), a larger body mass index (30 ± 4 vs 25 ± 3, p = 0.0001), and older donor age (27 ± 5 vs 23 ± 7 years, p = 0.005) than recipients with mild or moderate intimal thickness. Multiple regression analysis established that total cholesterol, low-density lipoprotein cholesterol, triglyceride levels, obesity indexes, donor age, and years following cardiac transplantation (p a0.01) were independent predictors of the severity of intimal thickening, and thus the severity of cardiac allograft vasculopathy. Hyperlipidemia, significant weight gain, and advanced donor age are predictors of the severity of intimal thickness by intravascular ultrasound. These findings may identify a group of cardiac transplant recipients in whom early intervention aimed at modification of hyperlipidemia and weight loss may be beneficial in preventing or delaying the development of cardiac allograft vasculopathy.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:08:36 EST