title: In vivo comparison between cardiac allograft vasculopathy and native atherosclerosis using near-infrared spectroscopy and intravascular ultrasound.
abstract: OBJECTIVE
  The aim was to compare cardiac allograft vasculopathy to native atherosclerosis by near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS).
  
  
  RESULTS
  Twenty-seven atherosclerotic (non-transplant) patients and 28 heart transplant recipients undergoing routine surveillance coronary angiography underwent NIRS-IVUS imaging of the left anterior descending coronary artery. In each proximal, middle, and distal coronary artery segment, the maxLCBI4mm [4-mm long segment with maximum lipid core burden index (LCBI)] and corresponding IVUS parameters were compared. MaxLCBI4mm was significantly greater among atherosclerotic patients than the transplant patients in both proximal and middle coronary artery segments, but not in the distal segment. There was a positive linear correlation between maxLCBI4mm and maximum plaque burden in both groups, but atherosclerotic patients demonstrated a smaller maxLCBI4mm than transplant recipients among segments with plaque burden <40%. Among segments with a maximum plaque burden ≥40%, native-atherosclerosis patients had a greater maxLCBI4mm compared with transplant patients (P = 0.015). Calcification was present in 72.9% of native atherosclerosis and 14.7% of transplant segments (P< 0.001). Among the 165 analysed segments, prevalence of lipid-rich plaque (LRP) with superficial attenuation (30.9 vs. 1.2%, P < 0.001) or calcified LRP (13.6 vs. 2.4%, P = 0.03) was significantly greater in native atherosclerosis compared with transplant patients. Conversely, the proportion of segments with non-LRP (46.4 vs. 11.1%, P < 0.001) was higher in transplant patients.
  
  
  CONCLUSIONS
  NIRS-IVUS imaging demonstrated early and accelerated lipid accumulation with smaller plaque burden and less calcium in patients after heart transplant when compared with patients with native atherosclerosis.
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA Peking University First Hospital, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zheng
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Tamim M
authors.initials: TM
authors.lastname: Nazif
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Yarden
authors.initials: Y
authors.lastname: Waksman
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Fuyu
authors.initials: F
authors.lastname: Qiu
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Luz
authors.initials: L
authors.lastname: Jaquez
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: LeRoy E
authors.initials: LE
authors.lastname: Rabbani
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Apfelbaum
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Ali
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Dalton
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Marboe
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Mancini
authors.affiliation: NewYork-Presbyterian/Columbia University Medical Center, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA Department of Cardiology, Shaare Zedek Medical Center, 12 Shmuel (Hans) Beyth Street, Jerusalem 91031, Israel weiszg@szmc.org.il.
authors.forename: Giora
authors.initials: G
authors.lastname: Weisz
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging; D016027:Heart Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D016019:Survival Analysis; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: atherosclerosis; cardiac allograft vasculopathy; intravascular ultrasound; near-infrared spectroscopy