PROHLÍŽENÍ ABSTRAKTA

ROLE OF DONOR TRANSMITTED DISEASE ON EARLY PROGRESSION OF CARDIAC ALLOGRAFT VASCULOPATHY: A STUDY USING HIGHLY AUTOMATED 3D OPTICAL COHERENCE TOMOGRAPHY ANALYSIS
Tématický okruh: Intervenční kardiologie
Typ: Ústní sdělení - lékařské , Číslo v programu: 402
Přihlášeno do: Soutěž mladých kardiologů

Pazderník M.1, Chen Z.2, Bedáňová H.3, Kautzner J.1, Melenovský V.1, Málek I.1, Krejčí J.4, Ozábalová E.4, Kovárník T.5, Šonka M.6

1 Klinika kardiologie, Institut klinické a experimentální medicíny- IKEM, Praha, 2 Institute for Biomedical Imaging, The University of Iowa, Iowa city, United States, 3 CKTCH, Brno, 4 I. interní kardioangiologická klinika, FNUSA, Brno, 5 II. interní klinika kardiologie a angiologie, VFN, Praha, 6 Institute for Biomedical Imaging, The University of Iowa, Iowa, United States


Introduction: Although several studies have evaluated the impact of donor-transmitted disease (DTD) on cardiac allograft vasculopathy (CAV) progression, results are still controversial.

Methods: Coronary OCT imaging was performed in 50 patients at 1 month and 12 months after heart transplant (HTx) (Figure 1). Full 3D analysis of the vessel wall enabled the development of quantitative focal wall disease descriptors to reflect the presence of DTD : 1) Donor-associated IT load [%], 2) Size of the largest region exhibiting increased IT [mm2], 3) Number of large regions exhibiting increased IT. The vessel disease phenotype was characterized as: (a) normal, (b) thrombofibrotic (2 or more areas with layered fibrotic plaque), (c) atherosclerotic (1 or more areas with lipid plaque), and (d) mixed atherosclerotic and thrombofibrotic.

Results: When assessing the relationship between focal wall disease descriptors and ΔIT, two of the three indices exhibited statistically significant correlations – 1) Donor-associated intimal thickness load (p=0.016) and 2) Number of large regions exhibiting increased IT (p<0.001). None of the phenotypes were associated with global intimal thickening at 12M (p=NS). However, the phenotype groups showed positive associations with maximal segmental intimal thickening (SIT) at 12M (p=0.033), ΔSITnormal phenotype=23.7±23.9µm, ΔSITathero phenotype =28.9±25.9µm, ΔSITmixed phenotype=31.4±34.9µm.

Conclusion: More diffuse pattern of DTD, represented by intimal thickness load and the number of large regions with increased IT at 1M, was associated with early diffuse intimal thickening. With respect to vessel phenotype, vessels with transferred atherosclerosis or more complicated mixed lesions were associated with more profound regional intimal thickening at 12M.

Study was supported by grants 16-27465A, IKEM-IN 00023001 and R01-EB004640.