Allograft aortopathy: an in vivo study of donor aorta involvement in cardiac allograft vasculopathy.
Limited histopathologic studies of failed cardiac allografts have demonstrated that cardiac allograft vasculopathy extends into the donor aorta; however, no study has examined the development of allograft aortic intimal proliferation in vivo in conjunction with coronary intimal hyperplasia. By using simultaneous intracoronary and intraaortic ultrasound, we studied 20 consecutive heart transplant recipients at 2.5 +/- 2.1 years after transplantation. The degree of coronary intimal thickening was strongly correlated with the development of intraaortic intimal hyperplasia (r = 0.90; p < 0.0001). Multivariate predictors of aortic intimal thickening included years after transplant (r = 0.47; p = 0.03), serum cholesterol level (r = 0.65, p = 0.003), and serum triglyceride level (r = 0.51; p = 0.03). Allograft aortopathy occurs in a similar manner to allograft coronary disease, thus providing support for the notion that an immunologic stimulus operating across the allograft vascular bed may be responsible for the development of cardiac allograft vasculopathy. Furthermore, this investigation provides insight into the putative role of hyperlipidemia in allograft vascular disease.
Mehra
M R
MR
Department of Internal Medicine, Ochsner Medical Institutions, New Orleans, La. 70121, USA.
Ventura
H O
HO
Stapleton
D D
DD
Karsan
A K
AK
Smart
F W
FW
Ramee
S R
SR
Collins
T J
TJ
D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D016027:Heart Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006965:Hyperplasia; D015228:Hypertriglyceridemia / Q000150:complications; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D014181:Transplantation Immunology; D014184:Transplantation, Homologous; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional
D007166:Immunosuppressive Agents; D014280:Triglycerides; D016572:Cyclosporine; D002784:Cholesterol