title: Donor-Transmitted Atherosclerosis Associated With Worsening Cardiac Allograft Vasculopathy After Heart Transplantation: Serial Volumetric Intravascular Ultrasound Analysis.
abstract: The influence of preexisting donor-transmitted atherosclerosis (DA) on cardiac allograft vasculopathy (CAV) development remains unclear.
  
  
  
  We performed 3-dimensional intravascular ultrasound (3D-IVUS) analysis in 42 heart transplantation (HTx) recipients at 2.1 ± 0.9 months (baseline) and 12.2 ± 0.4 months post-HTx, as well as consecutive 3D-IVUS analyses up to 3 years post-HTx in 35 of the 42 recipients. Donor-transmitted atherosclerosis was defined as a maximal intimal thickness of 0.5 mm or greater at baseline. Changes in volumetric IVUS parameters were compared in recipients with (DA group) and without DA (DA-free group) at baseline, 1 year, and 3 years post-HTx.
  
  
  
  Donor-transmitted atherosclerosis was observed in 57.1% of 42 recipients. The DA group exhibited a significantly greater increase in plaque volume at 1 year post-HTx (P < 0.001), leading to increased percent plaque volume (plaque volume/vessel volume, [%]) (P < 0.001) and decreased luminal volume (P = 0.021). Donor-transmitted atherosclerosis was independently associated with a greater increase in percent plaque volume during the first post-HTx year (P = 0.011). From 1 to 3 years post-HTx, the DA group underwent continuous reduction in luminal volume (P = 0.022). These changes resulted in a higher incidence of angiographic CAV at 3 years post-HTx in the DA group (58.8% vs 5.6%, P = 0.002).
  
  
  
  This volumetric IVUS study suggests that DA correlates with the worsening change in CAV several years post-HTx. Donor-transmitted atherosclerosis recipients may require more aggressive treatment to prevent subsequent CAV progression.
authors.affiliation: 1 Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 2 Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 3 Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 4 Department of Cardiology, Kumiai Kosei Hospital, Takayama, Gifu, Japan. 5 Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 6 Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 7 Department of Nursing, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 8 Department of Pharmacy, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 9 Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Takuya
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authors.lastname: Watanabe
authors.forename: Osamu
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authors.lastname: Seguchi
authors.forename: Masanobu
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authors.lastname: Yanase
authors.forename: Tomoyuki
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authors.forename: Takuma
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authors.lastname: Sato
authors.forename: Haruki
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authors.lastname: Sunami
authors.forename: Seiko
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authors.lastname: Nakajima
authors.forename: Yu
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authors.lastname: Kataoka
authors.forename: Kunihiro
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authors.lastname: Nishimura
authors.forename: Eriko
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authors.lastname: Hisamatsu
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authors.forename: Kyoichi
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authors.lastname: Hata
authors.forename: Hatsue
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authors.lastname: Ishibashi-Ueda
authors.forename: Yoshihiro
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authors.lastname: Miyamoto
authors.forename: Norihide
authors.initials: N
authors.lastname: Fukushima
authors.forename: Junjiro
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authors.lastname: Kobayashi
authors.forename: Takeshi
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authors.lastname: Nakatani
mesh_terms: D000328:Adult; D064591:Allografts; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006304:Health Status; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult