title: Risk Stratification for Cardiac Allograft Vasculopathy in Heart Transplant Recipients - Annual Intravascular Ultrasound Evaluation.
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) limits long-term success after heart transplant. We assessed the post-transplant risk factors for CAV development.
  
  
  RESULTS
  Patients who underwent heart transplant between May 1999 and December 2013 were included in this study. Patients (n=54) were divided into 2 groups according to the presence or absence of CAV progression after transplant. Coronary angiogram and intravascular ultrasound were conducted within 5-11 weeks after transplant, at 12 months, and annually thereafter. Scheduled endomyocardial biopsies were performed after transplant or whenever acute cellular rejection (ACR) or antibody-mediated rejection was suspected. Twenty-five of 54 patients (46.2%) had CAV progression. ACR ≥ International Society for Heart and Lung Transplantation grade 2 (ACR ≥ 2) and donor age >50 years were significantly associated with CAV development compared with ACR <2 and donor age <50 years. Patients with no history of ACR ≥ 2 and donor age ≤50 years had a significantly low risk of developing CAV compared with the other groups.
  
  
  CONCLUSIONS
  Donor age and history of ACR ≥ 2 are independent risk factors for CAV development. Identifying patients at risk of developing CAV is important for appropriate direction of resources and intensity of follow-up.
authors.affiliation: Department of Transplantation, National Cerebral and Cardiovascular Center.
authors.forename: Takuma
authors.initials: T
authors.lastname: Sato
authors.forename: Osamu
authors.initials: O
authors.lastname: Seguchi
authors.forename: Hatsue
authors.initials: H
authors.lastname: Ishibashi-Ueda
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yanase
authors.forename: Norihiro
authors.initials: N
authors.lastname: Okada
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kuroda
authors.forename: Eriko
authors.initials: E
authors.lastname: Hisamatsu
authors.forename: Haruki
authors.initials: H
authors.lastname: Sunami
authors.forename: Takuya
authors.initials: T
authors.lastname: Watanabe
authors.forename: Seiko
authors.initials: S
authors.lastname: Nakajima
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Wada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hata
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Norihide
authors.initials: N
authors.lastname: Fukushima
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakatani
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D016027:Heart Transplantation; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D012189:Retrospective Studies; D018570:Risk Assessment; D018084:Ultrasonography, Interventional; D014652:Vascular Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D007518:Isoantibodies