title: Impact of donor-transmitted atherosclerosis on early cardiac allograft vasculopathy: new findings by three-dimensional intravascular ultrasound analysis.
abstract: BACKGROUND
  The influence of donor-transmitted coronary atherosclerosis (DA) on plaque progression during the first year after cardiac transplantation (Tx) is unknown.
  
  
  METHODS
  Serial 3-dimensional intravascular ultrasound (IVUS) studies were performed within 8 weeks (baseline; BL) and at 1 year after Tx in 38 recipients. On the basis of maximum intimal thickness (MIT) at BL, recipients were divided into DA group (DA+; MIT≥0.5 mm, n=23) or non-DA group (DA-; MIT<0.5 mm, n=15). Plaque, lumen, and vessel volume indexes were calculated by volume/measured length (mm/mm) in the left anterior descending artery. Univariate and multivariate regression analyses were attempted to reveal clinical predictors of change in coronary dimensions.
  
  
  RESULTS
  During the first year after Tx, plaque volume index increased significantly in DA+ group, but did not change in DA- Group (DA+, 3.0±1.5 to 4.1±1.5 mm/mm, P<0.0001: DA-, 1.2±0.4 to 1.3±0.5 mm/mm, P=0.53). In both groups vessel volume index decreased significantly (DA+, 16.3±3.6 to 14.6±3.3 mm/mm, P=0.003: DA-, 13.5±4.1 to 12.0±3.3 mm/mm, P=0.01), as did lumen volume index (DA+, 13.2±3.1 to 10.5±2.7 mm/mm, P<0.0001: DA-, 12.2±3.7 to 10.7±3.0 mm/mm, P=0.004). Univariate and multivariate regression analyses revealed that DA was one of the strongest predictors for plaque progression.
  
  
  CONCLUSIONS
  DA was associated with significant plaque progression during the first year after Tx, and in conjunction with negative remodeling, may be an important determinant of cardiac allograft vasculopathy.
authors.affiliation: Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: Masao
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Ryota
authors.initials: R
authors.lastname: Sakurai
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirohata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Honda
authors.forename: Heidi N
authors.initials: HN
authors.lastname: Bonneau
authors.forename: Helen
authors.initials: H
authors.lastname: Luikart
authors.forename: Paul G
authors.initials: PG
authors.lastname: Yock
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Fitzgerald
authors.forename: Alan C
authors.initials: AC
authors.lastname: Yeung
authors.forename: Hannah A
authors.initials: HA
authors.lastname: Valantine
authors.forename: William F
authors.initials: WF
authors.lastname: Fearon
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D018450:Disease Progression; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012044:Regression Analysis; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014463:Ultrasonography / Q000379:methods*