Early detection of cardiac allograft vasculopathy using highly automated 3-dimensional optical coherence tomography analysis

Pazderník, Michal; Chen, Zhi; Bedáňová, Helena; Kautzner, Josef; Melenovský, Vojtěch; Karmazin, V.; Málek, I; Tomášek, Aleš; Ozábalová, Eva; Krejčí, Jan; Franeková, Janka; Wahle, Andreas; Zhang, Honghai; Kovárník, Tomáš; Sonka, Milan

doi:10.1016/j.healun.2018.04.002

Cited by 29 publications

(25 citation statements)

References 30 publications

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“…Cardiac allograft vasculopathy ‐related graft failure accounts for the majority of patient mortality within 5‐10 years, surpassing the contributions of malignancies and infections . Rapid development of CAV is diagnosed in a high proportion of HTx patients, occurring as early as within 1 year after the index procedure . Early identification of such patients is of extreme importance, since it can favorably affect CAV‐related allograft failure rates and the subsequent need for re‐transplantations .…”

Section: Discussionmentioning

confidence: 99%

“…18,19 Rapid development of CAV is diagnosed in a high proportion of HTx patients, occurring as early as within 1 year after the index procedure. 15,18 Early identification of such patients is of extreme importance, since it can favorably affect CAV-related allograft failure rates and the subsequent need for re-transplantations. 19 Furthermore, elevated resting HR after HTx might be an independent, and relatively easily modifiable, risk factor for the development of CAV or other systemic cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

“…For each frame of all OCT pullbacks, luminal, intimal, and medial surfaces were automatically segmented using a fully three-dimensional LOGISMOS graph-based approach developed at the University of Iowa, 12,13 as previously documented. 14,15 Boundaries were identified as OCT brightness changes showing tissue interfaces between adjacent wall layers. Automatically identified borders were efficiently edited using our Just-Enough-Interaction method adapted for the OCT segmentation environment.…”

Section: Image Interpretationmentioning

confidence: 99%

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Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis

Pazderník

Wichterle

Chen

et al. 2020

Clinical Transplantation

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Introduction Heart rate slowing agents are frequently prescribed to manage heart transplant (HTx) patients with the assumption that higher heart rate is a risk factor in cardiovascular disease. Patients and Methods This prospective two‐center study investigated early progression of cardiac allograft vasculopathy (CAV) in 116 HTx patients. Examinations by coronary optical coherence tomography and 24‐hour ambulatory ECG monitoring were performed both at baseline (1 month after HTx) and during follow‐up (12 months after HTx). Results During the first post‐HTx year, we observed a significant reduction in the mean coronary luminal area from 9.0 ± 2.5 to 8.0 ± 2.4 mm2 (P < .001), and progression in mean intimal thickness (IT) from 106.5 ± 40.4 to 130.1 ± 53.0 µm (P < .001). No significant relationship was observed between baseline and follow‐up mean heart rates and IT progression (R = .02, P = .83; R = −.13, P = .18). We found a mild inverse association between beta‐blocker dosage at 12 months and IT progression (R = −.20, P = .035). Conclusion Our study did not confirm a direct association between mean heart rate and progression of CAV. The role of beta blockers warrants further investigation, with our results indicating that they may play a protective role in early CAV development.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Image Interpretationmentioning

confidence: 99%

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Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis

Pazderník

Wichterle

Chen

et al. 2020

Clinical Transplantation

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“…A comparison of IVUS and OCT is described in Table III and presented in Figure 1. Apart from improved plaque characterisation, one of the key advantages of OCT over IVUS is significantly lower interobserver variability, which after inclusion of more specified 3-D algorithms could be even further decreased [37,38].…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

“…Plaques with higher VS were at significantly higher risk of volume increase in 12 months, and VS was the only risk factor of volume increase in multivariate analysis In 45% of patients, abnormalities in vascular wall structure were found at 3 months post-OHT Mean IT increases by 20% to the value of 1.9 mm in the first year after OHT, but LA decreased only by 2% in that time. Presence of layered fibrotic plaques increased almost 5 times to 4.8% with no significant difference in extent of lipid or calcified plaque components Pazdernik M, 2018 [37] 50 as routine follow-up at 1 month and repeatedly 12 months after OHT Determination of a novel method to assess IT and MT with OCT…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

The role of optical coherence tomography and other intravascular imaging modalities in cardiac allograft vasculopathy

Dyrbuś

Gąsior

Szyguła‐Jurkiewicz

et al. 2020

pwki

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Orthotopic heart transplantation (OHT) is the standard-of-care for end-stage heart disease. Although a significant improvement in the prognosis of patients after OHT has been observed in recent years, their overall mortality remains relatively high, with a median survival of approximately 10 years after transplantation. One of the primary causes of death in patients after OHT is cardiac allograft vasculopathy (CAV), the condition developing specifically in the coronary vasculature after OHT, the pathophysiology of which is still inadequately known. It is estimated that CAV development and progression is responsible for approximately 30% of deaths within five years post-OHT. According to the International Society for Heart and Lung Transplantation (ISHLT) Nomenclature for CAV, its presence should be assessed primarily by the coronary angiography performed routinely after OHT, mostly due to its wide availability, reproducibility, and low complication rate. However, the analysis of CAV in coronary angiography has limitations, mostly concerning its-sometimes inadequate-sensitivity and specificity. Hence, there is a growing need for the introduction of more accurate methods of CAV assessment, such as intravascular imaging, which through a thorough evaluation of the arterial wall structure and thickness allows the drawbacks of routine angiography to be minimised. The aim of the article was to critically summarise the current findings derived from the analysis of CAV by optical coherence tomography, the other intravascular imaging modalities, such as intravascular ultrasound (IVUS) and IVUS-derived virtual histology, along with physiological assessment with the use of the fractional flow reserve.

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Cardiac Allograft Vasculopathy

Mazur,

Eisen

2023

Textbook of Transplantation and Mechanical Support for End‐Stage Heart and Lung Disease

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Early detection of cardiac allograft vasculopathy using highly automated 3-dimensional optical coherence tomography analysis

Cited by 29 publications

References 30 publications

Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis

Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis

The role of optical coherence tomography and other intravascular imaging modalities in cardiac allograft vasculopathy

Cardiac Allograft Vasculopathy

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