title: Assessment of early atherosclerosis in de novo heart transplant recipients: analysis with intravascular ultrasound-derived radiofrequency analysis.
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) is the major limitation in survival of patients after heart transplantation. Cardiac allograft vasculopathy is angiographically silent in the early phase after operation. Intravascular ultrasound (IVUS) is a more sensitive method to detect the early stages of CAV and provides information about its development. Recent IVUS studies demonstrated a rapid progression of CAV within the first year after transplantation as a predictor of morbidity and mortality.
  
  
  OBJECTIVE
  This study assessed the plaque composition of early atherosclerosis in transplant patients by radiofrequency analysis.
  
  
  METHODS
  Coronary angiography and IVUS with Virtual Histology (VH) software (Real-Time VH, Volcano Corp, Rancho Cordova, CA) were used to assess 18 patients early after heart transplantation (1.71 +/- 0.47 months). The plaque composition was determined by IVUS radiofrequency data analysis. Tissue maps were reconstructed from radiofrequency data using VH-IVUS software. The VH-IVUS acquisition was performed with standardized IVUS (EagleEye catheter; 2.9 F/20 MHz; Volcano Corp) and the VH-IVUS console (Volcano Corp).
  
  
  RESULTS
  Coronary angiography did not show any wall irregularities. Intravascular ultrasound demonstrated donor-transmitted atherosclerosis in 6 of 18 patients (33.33%). The incidence, amount of plaque burden, and plaque composition was significantly related to donor age. By VH-IVUS analysis, the plaque composition consisted mainly of fibrotic tissue.
  
  
  CONCLUSIONS
  Donor-transmitted coronary atherosclerosis is present early after heart transplantation and cannot be detected by coronary angiography. VH-IVUS gives detailed information about the plaque distribution and the plaque composition.
authors.affiliation: Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik-Innenstadt, Munich, Germany. Andreas.Koenig@med.uni-muenchen.de
authors.forename: Andreas
authors.initials: A
authors.lastname: König
authors.forename: Eckehard
authors.initials: E
authors.lastname: Kilian
authors.forename: Johannes
authors.initials: J
authors.lastname: Rieber
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Schiele
authors.forename: Marcus
authors.initials: M
authors.lastname: Leibig
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Sohn
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.forename: Volker
authors.initials: V
authors.lastname: Klauss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D018084:Ultrasonography, Interventional / Q000379:methods*