title: [Prospective study of the frequency and extent of donor-transmitted coronary disease after heart transplantation by intravascular ultrasound].
abstract: OBJECTIVE
  Cardiac allograft vasculopathy influences long-term survival of patients after heart transplantation. Donor-transmitted coronary artery disease may contribute to the further development of cardiac allograft vasculopathy. The aim of this study was to characterize by intracoronary ultrasound the extent and frequency of transmitted coronary artery disease.
  
  
  METHODS
  Intravascular ultrasound studies were performed at routine angiography in 33 patients (26 men, 7 women, mean age 51 [23-69] years) early after heart transplantation. Plaque morphology was analysed in 153 coronary segments of 52 epicardial coronary arteries.
  
  
  RESULTS
  Relevant atherosclerosis (defined as maximal plaque thickness > or = 0.5 mm in at least one coronary segment) was found in 17 patients (52%), while angiography showed irregularities in only 7 patients (21%). Maximal plaque thickness in patients with relevant atherosclerosis was 1.13 +/- 0.32 mm, mean plaque index was 19.2 +/- 10.2%. Plaque formation was eccentric, and plaques were predominantly located in proximal segments. Morphologic changes affecting more than one segment were found in 52% of the patients. Comparing clinical factors, only donor age predicted the degree of atherosclerosis.
  
  
  CONCLUSIONS
  In more than one half of the patients studied early after heart transplantation, Intravascular ultrasound revealed epicardial atherosclerotic lesions which were incompletely identified by coronary angiography. The degree of atherosclerosis was closely related to donor age. The potential influence of donor transmitted coronary artery disease on the progression of transplant coronary artery disease requires further longitudinal studies.
authors.affiliation: Kardiologische Abteilung, Klinikum Innenstadt.
authors.forename: V
authors.initials: V
authors.lastname: Klauss
authors.forename: K H
authors.initials: KH
authors.lastname: Henneke
authors.forename: J
authors.initials: J
authors.lastname: Rieber
authors.forename: C
authors.initials: C
authors.lastname: Spes
authors.forename: B
authors.initials: B
authors.lastname: Meiser
authors.forename: U
authors.initials: U
authors.lastname: Siebert
authors.forename: C E
authors.initials: CE
authors.lastname: Angermann
authors.forename: K
authors.initials: K
authors.lastname: Theisen
authors.forename: H
authors.initials: H
authors.lastname: Mudra
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014019:Tissue Donors; D018084:Ultrasonography, Interventional