title: Comparison Between Cardiac Allograft Vasculopathy and Native Coronary Atherosclerosis by Optical Coherence Tomography.
abstract: We sought to explore differences in distribution and morphology of coronary lesions comparing cardiac allograft vasculopathy and native coronary atherosclerosis (NCA) using intravascular imaging with optical coherence tomography (OCT). At the time of routine surveillance angiography, 17 heart transplant (HT) recipients with a history of high-grade cellular rejection (HGR) and 43 HT recipients with none/mild (low)-grade rejection underwent OCT imaging of the left anterior descending and were compared to 60 patients with NCA without HT. Compared with patients with NCA, patients with HGR had similar intima areas but smaller external elastic lamina areas (7.9 mm(2) [6.3, 11.2] versus 6.6 mm(2) [4.8, 7.5], p = 0.02) resulting in smaller lumen areas (4.5 mm(2) [3.4, 6.6] versus 3.3 mm(2) [2.8, 4.7], p = 0.04) in distal segments and smaller lumen diameters in side branches (1.28 mm [1.19, 1.37] versus 1.09 mm [0.94, 1.24], p = 0.04). Compared with patients with NCA, lesions in patients with HT were more homogeneous, involving the entire coronary vascular tree. Patients with HGR had a higher prevalence of macrophages involving ≥1 quadrant in all 3 segments compared with patients with NCA. The number of microvessels was greater in patients with both HGR and LGR HT versus NCA. In conclusion, distinct findings in the distribution and morphology of coronary lesions between HT recipients and patients with NCA are evident by OCT imaging, suggesting that OCT might be useful to help differentiate cardiac allograft vasculopathy from NCA in vivo.
authors.affiliation: Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China; Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.
authors.forename: Peiren
authors.initials: P
authors.lastname: Shan
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Dong
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.
authors.forename: Akiko
authors.initials: A
authors.lastname: Maehara
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.
authors.forename: Tamim M
authors.initials: TM
authors.lastname: Nazif
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Ali
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York.
authors.forename: LeRoy E
authors.initials: LE
authors.lastname: Rabbani
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Apfelbaum
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York.
authors.forename: Kate
authors.initials: K
authors.lastname: Dalton
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Marboe
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Mancini
authors.affiliation: Clinical Trials Center, Cardiovascular Research Foundation, New York, New York.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.affiliation: Division of Cardiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel. Electronic address: weiszg@szmc.org.il.
authors.forename: Giora
authors.initials: G
authors.lastname: Weisz
mesh_terms: D000368:Aged; D064591:Allografts; D050197:Atherosclerosis / Q000175:diagnosis*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003331:Coronary Vessels / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D017539:Tunica Intima / Q000473:pathology