[Changes in the diameter of the coronary arteries in heart transplant recipients with angiographically normal vessels during five years].
BACKGROUND
Diffuse or focal coronary artery narrowing is a frequent complication of cardiac transplantation. Coronary enlargement has also been described although it is less known. To study the changes of the coronary arteries in transplant recipients, we have performed a quantitative study throughout 5 years.


METHODS
Serial coronary angiography was performed annually in all survivors of heart transplant. Forty four patients with visually normal coronary arteries and at least 5 years of evolution were selected for this study. Quantitative measurements of the diameter of the coronary arteries were performed in each angiogram at different levels: proximal, medium and distal left anterior descending coronary artery; proximal and distal left circumflex; proximal, medium and distal right coronary artery. Changes in diameter were compared throughout the 5 years.


RESULTS
In the entire group of patients there was a small increase in the diameter of each segment. Taking each patient separately, an enlargement of the diameter of the proximal descending coronary artery was seen in 17 cases; medium descending coronary artery in 13; distal descending coronary artery in 8; proximal left circumflex in 11; distal left circumflex in 14; proximal right coronary artery in 18; medium right coronary artery in 18 and distal right coronary artery in 15. In total, 114 of 352 coronary segments (32%) underwent dilatation. Only 6 patients failed to have dilatation of any segment.


CONCLUSIONS
Enlargement of the coronary arterial diameter was seen in 32% of segments of the main coronary arteries in heart transplant recipients with angiographically normal coronary arteries during 5 years of evolution. This could be due to intimal thickening with overcompensation by an additional vessel enlargement with net lumen gain.
Coma-Canella
I
I
Departamento de Cardiología y Cirugía Cardiovascular, Facultad de Medicina, Universidad de Navarra, Pamplona. icoma@unav.es
Maceira
A
A
Díaz Dorronsoro
I
I
Calabuig
J
J
Martínez
A
A
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000033:anatomy & histology*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
Cambios de diámetro de las arterias coronarias en receptores de transplante cardíaco con vasos angiográficamente normales durante cinco años.