Presence of severe intimal thickening by intravascular ultrasonography predicts cardiac events in cardiac allograft vasculopathy

Mehra, M. R., Ventura, H. O., Stapleton, D. D., Smart, F. W., Collins, T. C. and Ramee, S. R. (1995) Presence of severe intimal thickening by intravascular ultrasonography predicts cardiac events in cardiac allograft vasculopathy. Journal of Heart and Lung Transplantation, 14 4: 632-639.

Author Mehra, M. R.
Ventura, H. O.
Stapleton, D. D.
Smart, F. W.
Collins, T. C.
Ramee, S. R.
Title Presence of severe intimal thickening by intravascular ultrasonography predicts cardiac events in cardiac allograft vasculopathy
Journal name Journal of Heart and Lung Transplantation   Check publisher's open access policy
ISSN 1053-2498
1557-3117
Publication date 1995-07-01
Year available 1995
Sub-type Article (original research)
Open Access Status Not Open Access
Volume 14
Issue 4
Start page 632
End page 639
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Formatted abstract
Background: The clinical utility of intimal hyperplasia detected by intravascular ultrasonography in predicting cardiac events in heart transplant recipients with cardiac allograft vasculopathy has not been previously investigated.

Methods: Intravascular ultrasonographic examination of 74 consecutive heart transplant recipients, including 62 men and 12 women with a mean age of 51 ± 10 years (range 22 to 68 years), was performed at the time of annual angiography. Two groups of study patients were identified: group I consisted of patients with minimal, mild, or moderate intimal thickness by intravascular ultrasonography, whereas group II patients had severe intimal thickness.

Results: Patient characteristics were similar in both groups except for higher serum triglycerides (220 ± 95 versus 165 ± 79 mg/dl), more advanced donor age (28 ± 11 versus 23 ± 6 years) and greater duration of follow-up after transplantation (3.3 ± 1.4 versus 1.8 ± 1.2 years) in group II patients with severe intimal thickening (p < 0.01). Cardiac events were defined as the occurrence of sudden death, myocardial infarction, or the need for coronary revascularization via percutaneous or surgical intervention. One cardiac event occurred in group I patients (sudden death), whereas seven events were noted in the group II patients (p = 0.006). Cardiac events in the group of patients with severe intimal thickening included four patients with sudden cardiac death and three patients who underwent percutaneous revascularization procedures involving directional coronary atherectomy. Angiograms were normal in 62% of patients who had cardiac events.

Conclusions: This study represents one of the first reports that provides evidence that severe intimal hyperplasia predicts the development of cardiac events even in the presence of a normal coronary angiogram.
Keyword Cardiac & Cardiovascular Systems
Respiratory System
Surgery
Transplantation
Cardiovascular System & Cardiology
Respiratory System
Surgery
Transplantation
CARDIAC & CARDIOVASCULAR SYSTEMS
RESPIRATORY SYSTEM
TRANSPLANTATION
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, 20:12:06 EST