title: Relationship between ventricular pressure and coronary artery disease in asymptomatic adult heart transplant recipients.
abstract: BACKGROUND
  The association between data of right heart catheterization and cardiac allograft vasculopathy (CAV) in adult heart transplant (HTx) recipients remains to be determined.
  
  
  RESULTS
  This is an observational, retrospective study, including all consecutive asymptomatic HTx patients undergoing routine right and left catheterization. The independent predictive power of pulmonary capillary wedge pressure (PCWP) to predict CAV (classified according to working formulation of a standardized nomenclature for CAV-2010) was the primary end point. Seventy-one patients were included, with a mean time from HTx to procedure of 19 ± 25 months. At coronary angiography first degree of CAV was found in eight patients (11.2%), second degree of CAV in two patients (2.8%), and third in two (2.8%). PCWP values were significantly higher in patients with CAV compared with patients without CAV (17.5 ± 7.5 vs. 10.4 ± 5.6, P < 0.001) and values of 15 mmHg or greater had an AUC of 0.71 (0.48-0.92), with a sensitivity of 71% and a specificity of 73% in predicting CAV, with an independent relationship confirmed at logistic regression analysis (odds ratio 1.28, IC 1.06-1.53; P = 0.008).
  
  
  CONCLUSIONS
  A significantly elevated PCWP at the time of the diagnosis of transplant coronary artery disease may be considered as an early marker of CAV, especially in asymptomatic HTx recipients.
authors.affiliation: Division of Cardiology, 'Città della Salute e della Scienza', Ospedale S.G. Battista -- Molinette, University of Turin, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Iannaccone
authors.forename: Ilaria
authors.initials: I
authors.lastname: Meynet
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Omedè
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: Salma
authors.initials: S
authors.lastname: Taha
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bertaina
authors.forename: Chiara
authors.initials: C
authors.lastname: Colaci
authors.forename: Ludovica
authors.initials: L
authors.lastname: Marangoni
authors.forename: Marco
authors.initials: M
authors.lastname: Ribezzo
authors.forename: Massimo
authors.initials: M
authors.lastname: Boffini
authors.forename: Mauro
authors.initials: M
authors.lastname: Rinaldi
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000328:Adult; D002423:Cause of Death; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011669:Pulmonary Wedge Pressure; D012189:Retrospective Studies; D017725:Ventricular Pressure