Long-Term Outcome After Heart Transplantation Predicted by Quantitative Myocardial Blush Grade in Coronary Angiography

Abstract

The purpose of our study was to investigate whether the quantification of myocardial blush grade (MBG) during surveillance coronary angiography can predict long-term outcome after heart transplantation (HT). In 105 HT recipients who underwent cardiac catheterization, cardiac allograft vasculopathy (CAV) was assessed visually using the ISHLT grading scale (prospective cohort study). MBG was quantified by dividing the plateau of contrast agent gray-level intensity (G max ) by the time-to-peak intensity (T max ). In a subgroup (n ¼ 72), myocardial perfusion index by cardiac magnetic resonance imaging (CMR) was assessed.

Comprehensive Bio-Imaging Using Myocardial Perfusion Reserve Index During Cardiac Magnetic Resonance Imaging and High-Sensitive Troponin T for the Prediction of Outcomes in Heart Transplant Recipients

“…All procedures complied with the Declaration of Helsinki, were approved by our local ethic committee and all patients gave written informed consent. Part of our patients (n ¼ 63 of 108, 58% of the present cohort) were included in previous reports, where the ability of angiographic myocardial blush grade was investigated to predict cardiac outcomes in transplant recipients (7).…”

“…This is part of our institutional protocol, performed in HT recipients, as described previously (7)(8)(9). Briefly, a standardized imaging protocol was used, aiming at the assessment of baseline parameters of the left ventricle such as left ventricular (LV) diameters, septal and lateral wall thickness and, ejection fraction using cine imaging.…”

“…Coronary angiograms were performed in a standardized fashion, as described previously (7). Coronary vessels were classified by coronary angiography, based on the ISHLT nomenclature for CAV (12).…”