title: Monitoring of allograft vasculopathy by intravascular ultrasound one month and one year after heart transplantation: A single center study.
abstract: OBJECTIVE
  The aim of this trial was to use intravascular ultrasound (IVUS) to determine whether cardiac allograft vasculopathy (CAV) starts progressing during the first year after heart transplantation (HTx).
  
  
  METHODS
  We retrospectively analyzed 51 patients (11 women) who received heart transplants in our center between January 2010 and September 2013 and underwent coronary angiography as well as IVUS examination one month and one year after HTx. Patients with proven calcification and fibrotic plates in the IVUS examination one month after HTx constituted a group with defined donor-transmitted atherosclerosis (DTA). In patients without DTA, measurements of maximal intimal thickening (MIT) were made in two predetermined locations.
  
  
  RESULTS
  Eight of the 51 patients had DTA, while 43 did not. These were divided based on maximal intimal thickness (MIT) into a group with MIT < 0.5 mm (27) and MIT ≥ 0.5 mm (16). No patient with MIT < 0.5 mm developed allograft vasculopathy within one year after HTx. CAV developed in three patients (P = 0.045) out of the 16 patients with MIT ≥ 0.5. In patients with DTA, a statistically significant deterioration in percent area stenosis (PAS) occurred in both artery sections (P = 0.01).
  
  
  CONCLUSIONS
  Our trial showed that CAV progresses during the first year after HTx significantly more frequently in patients with DTA and MIT ≥ 0.5 mm. It is essential in these patients to implement an IVUS control examination one year after transplantation. The results can lead to a change in treatment strategy to prevent further progress of the disease.
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.|International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Helena
authors.initials: H
authors.lastname: Bedanova
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.|International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Orban
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Tretina
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.|International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Fila
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.|International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Horvath
authors.affiliation: International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Krejci
authors.affiliation: Center of Cardiovascular and Transplant Surgery, Brno, Czech Republic.|International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Nemec
mesh_terms: D000328:Adult; D064591:Allografts / Q000098:blood supply / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous; D017539:Tunica Intima / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional
keywords: IVUS examination; allograft vasculopathy; heart transplantation