Donor specific anti-HLA antibodies and cardiac allograft vasculopathy: A prospective study using highly automated 3-D optical coherence tomography analysis

Pazderník, Michal; Bedáňová, Helena; Chen, Zhi; Kautzner, Josef; Melenovský, Vojtěch; Málek, I; Slavčev, Antonij; Bartonova, Michaela; Karmazin, V.; Eckhardt, Tomáš; Tomášek, Aleš; Ozábalová, Eva; Kovárník, Tomáš; Wohlfahrt, Peter; Sonka, Milan

doi:10.1016/j.trim.2020.101340

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…9,10 This OCT analysis approach was independently validated in an international study on data from the Aarhus University Medical Center 11 and used for analysis in several other studies. 9,12 (Figure 1). The OCT analysis is comprehensibly described in Supplementary Material (Appendix A).…”

Section: Oct Analysismentioning

confidence: 99%

Acetylsalicylic acid use and development of cardiac allograft vasculopathy: A national prospective study using highly automated 3‐D optical coherence tomography analysis

Mayerova,

Wohlfahrt,

Sonka

et al. 2024

Clinical Transplantation

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BackgroundThere is conflicting evidence on the role of acetylsalicylic acid (ASA) use in the development of cardiac allograft vasculopathy (CAV).MethodsA nationwide prospective two‐center study investigated changes in the coronary artery vasculature by highly automated 3‐D optical coherence tomography (OCT) analysis at 1 month and 12 months after heart transplant (HTx). The influence of ASA use on coronary artery microvascular changes was analyzed in the overall study cohort and after propensity score matching for selected clinical CAV risk factors.ResultsIn total, 175 patients (mean age 52 ± 12 years, 79% male) were recruited. During the 1‐year follow‐up, both intimal and media thickness progressed, with ASA having no effect on its progression. However, detailed OCT analysis revealed that ASA use was associated with a lower increase in lipid plaque (LP) burden (p = .013), while it did not affect the other observed pathologies. Propensity score matching of 120 patients (60 patient pairs) showed similar results, with ASA use associated with lower progression of LPs (p = .002), while having no impact on layered fibrotic plaque (p = .224), calcification (p = .231), macrophage infiltration (p = .197), or the absolute coronary artery risk score (p = .277). According to Kaplan–Meier analysis, ASA use was not associated with a significant difference in survival (p = .699)ConclusionThis study showed a benefit of early ASA use after HTx on LP progression. However, ASA use did not have any impact on the progression of other OCT‐observed pathologies or long‐term survival.

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Section: Oct Analysismentioning

confidence: 99%

Acetylsalicylic acid use and development of cardiac allograft vasculopathy: A national prospective study using highly automated 3‐D optical coherence tomography analysis

Mayerova,

Wohlfahrt,

Sonka

et al. 2024

Clinical Transplantation

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“…Since OCT can detect small structural changes in coronary arteries, it may be useful for elucidating the pathophysiology of CAV. The association between rejection and OCT findings has been evaluated in several studies [55][56][57]. A retrospective study comparing OCT findings in pediatric and adult HTX recipients suggested age-and time-dependent differences in the prevalence of absolute and relative intimal hyperplasia [58].…”

Section: Coronary Angiography Intravascular Ultrasound and Optical Co...mentioning

confidence: 99%

Diagnostic Intravascular Imaging Modalities for Cardiac Allograft Vasculopathy

Tsukamoto¹,

Watanabe²,

Mochizuki³

et al. 2022

Heart Transplantation - New Insights in Therapeutic Strategies

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Cardiac allograft vasculopathy (CAV) is one of the major factors limiting long-term survival after heart transplantation (HTX). Typically, concentric vascular thickening and fibrosis with marked intimal proliferation are found in CAV. Most of HTX patients often remain free from symptoms of typical angina. Therefore, surveillance diagnostic exams are often performed. The gold standard of diagnosing CAV is coronary angiography (CAG). However, CAG can often be a less sensitive modality for the detection of diffuse concentric lesions. Intravascular ultrasound (IVUS) is helpful for direct imaging of vessel walls and provides useful information about coronary intimal thickening; however, it is difficult to evaluate plaque morphology in detail. Optimal coherence tomography (OCT), which delivers high resolution of 10 μm, can provide more details on plaque morphology than conventional imaging modalities. Recently, OCT imaging revealed new insight in CAV such as the development of atherosclerotic lesions and complicated coronary lesions. We review the pathogenesis, clinical features, diagnosis of CAV, with a particular focus on diagnostic intravascular imaging modalities.

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“…Medial thickening could be an important early indicator of CAV, reflecting increased smooth muscle cell mitotic activity in the media before infiltration of the intimal layer. 32…”

Section: Rejection Donor-specific Antibodies and Cav By Octmentioning

confidence: 99%

Optical Coherence Tomography in Cardiac Allograft Vasculopathy

Acharya

Loyaga‐Rendon

Chatterjee

et al. 2021

Circ: Heart Failure

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Cardiac allograft vasculopathy (CAV) is a challenging complication of heart transplantation. CAV pathophysiology is incompletely understood, standard screening modalities such as angiography have significant limitations, and currently available therapies have only modest efficacy in preventing progression. Optical coherence tomography is a light-based technique that provides microscopic level catheter-based intravascular imaging and has dramatically expanded our understanding of CAV, demonstrating it to be a complex, heterogeneous, and dynamic process. This review covers characteristics and uses of optical coherence tomography, including vessel characterization, serial use to assess progression of disease, guiding percutaneous intervention, and monitoring response to CAV therapies. We also discuss the potential of optical coherence tomography in providing individualized assessment and enable customized CAV therapies, which may lead to improvements in long-term transplant outcomes.

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Donor specific anti-HLA antibodies and cardiac allograft vasculopathy: A prospective study using highly automated 3-D optical coherence tomography analysis

Cited by 7 publications

References 31 publications

Acetylsalicylic acid use and development of cardiac allograft vasculopathy: A national prospective study using highly automated 3‐D optical coherence tomography analysis

Acetylsalicylic acid use and development of cardiac allograft vasculopathy: A national prospective study using highly automated 3‐D optical coherence tomography analysis

Diagnostic Intravascular Imaging Modalities for Cardiac Allograft Vasculopathy

Optical Coherence Tomography in Cardiac Allograft Vasculopathy

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