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Paediatric heart transplantation recipients ≥7 years of age receiving donors with pre-existing coronary atherosclerosis showed progressive coronary artery disease

Part of: Advanced Imaging

Published online by Cambridge University Press:  27 September 2021

Mi Jin Kim Open the ORCID record for Mi Jin Kim [Opens in a new window] ,
Jeong Jin Yu Open the ORCID record for Jeong Jin Yu [Opens in a new window] ,
Seulgi Cha ,
Jae Suk Baek ,
Eun Seok Choi ,
Bo Sang Kwon ,
Chun Soo Park ,
Tae-Jin Yun  and
Young-Hwue Kim
Mi Jin Kim
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jeong Jin Yu*
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Seulgi Cha
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jae Suk Baek
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Eun Seok Choi
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Bo Sang Kwon
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Chun Soo Park
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Tae-Jin Yun
Affiliation:
Department of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Young-Hwue Kim
Affiliation:
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
*
Author for correspondence: J. J. Yu, MD, Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, South Korea. Tel: +82-02-3010-3924. E-mail: jjyu@amc.seoul.kr
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Abstract

Background:

This study aimed to determine the effect of donor-transmitted atherosclerosis on the late aggravation of cardiac allograft vasculopathy in paediatric heart recipients aged ≥7 years.

Methods:

In total, 48 patients were included and 23 had donor-transmitted atherosclerosis (baseline maximal intimal thickness of >0.5 mm on intravascular ultrasonography). Logistic regression analyses were performed to identify risk factors for donor-transmitted atherosclerosis. Rates of survival free from the late aggravation of cardiac allograft vasculopathy (new or worsening cardiac allograft vasculopathy on following angiograms, starting 1 year after transplantation) in each patient group were estimated using the Kaplan–Meier method and compared using the log-rank test. The effect of the results of intravascular ultrasonography at 1 year after transplantation on the late aggravation of cardiac allograft vasculopathy, correcting for possible covariates including donor-transmitted atherosclerosis, was examined using the Cox proportional hazards model.

Results:

The mean follow-up duration after transplantation was 5.97 ± 3.58 years. The log-rank test showed that patients with donor-transmitted atherosclerosis had worse survival outcomes than those without (p = 0.008). Per the multivariate model considering the difference of maximal intimal thickness between baseline and 1 year following transplantation (hazard ratio, 22.985; 95% confidence interval, 1.948–271.250; p = 0.013), donor-transmitted atherosclerosis was a significant covariate (hazard ratio, 4.013; 95% confidence interval, 1.047–15.376; p = 0.043).

Conclusion:

Paediatric heart transplantation recipients with donor-transmitted atherosclerosis aged ≥7 years had worse late cardiac allograft vasculopathy aggravation-free survival outcomes.

Keywords

Atherosclerosiscardiac allograft vasculopathychildrenheart transplantationintravascular ultrasonography
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 7 , July 2022 , pp. 1104 - 1111
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Dipchand, AI, Edwards, LB, Kucheryavaya, AY, et al. The registry of the International Society for Heart and Lung Transplantation: seventeenth official pediatric heart transplantation report-2014; focus theme: retransplantation. J Heart Lung Transplant 2014; 33: 985–995.CrossRefGoogle ScholarPubMed
Mehra, MR, Crespo-Leiro, MG, Dipchand, A, et al. International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy-2010. J Heart Lung Transplant 2010; 29: 717–727.CrossRefGoogle ScholarPubMed
Rickenbacher, PR, Pinto, FJ, Chenzbraun, A, et al. Incidence and severity of transplant coronary artery disease early and up to 15 years after transplantation as detected by intravascular ultrasound. J Am Coll Cardiol 1995; 25: 171–177.CrossRefGoogle ScholarPubMed
Nissen, S. Coronary angiography and intravascular ultrasound. Am J Cardiol 2001; 18: 692–696.Google Scholar
Cai, Q, Rangasetty, UC, Barbageelata, A, Fujise, K, Koerner, MM. Cardiac allograft vasculopathy: advances in diagnosis. Cardiol Rev 2011; 19: 30–35.CrossRefGoogle ScholarPubMed
Kuhn, MA, Jutzy, KR, Deming, DD, et al. The medium-term findings in coronary arteries by intravascular ultrasound in infants and children after heart transplantation. J Am Coll Cardiol 2000; 36: 250–254.CrossRefGoogle ScholarPubMed
Mendiz, OA, Gamboa, P, Renedo, MF, Lev, GA, Favaloro, LE, Bertolotti, AM. Intravascular ultrasound for cardiac allograft vasculopathy. Clin Transplant 2021; 35: e14167.CrossRefGoogle ScholarPubMed
Kobashigawa, JA, Tobis, JM, Starling, RC, et al. Multicenter intravascular ultrasound validation study among heart transplant recipients: outcomes after five years. J Am Coll Cardiol 2005; 45: 1532–1537.CrossRefGoogle ScholarPubMed
Nelson, LM, Rossing, K, Ihlemann, N, Boesgaard, S, Engstrøm, T, Gustafsson, F. Intravascular ultrasound-guided selection for early noninvasive cardiac allograft vasculopathy screening in heart transplant recipients. Clin Transplant 2020; 34: e14124.CrossRefGoogle ScholarPubMed
Zoeller, BB, Miyamoto, SD, Younoszai, AK, Landeck, BF. Longitudinal strain and strain rate abnormalities precede invasive diagnosis of transplant coronary artery vasculopathy in pediatric cardiac transplant patients. Pediatr Cardiol 2016; 37: 656–661.CrossRefGoogle ScholarPubMed
Boruta, RJ, Miyamoto, SD, Younoszai, AK, Patel, SS, Landeck, BF. Worsening in longitudinal strain and strain rate anticipates development of pediatric transplant coronary artery vasculopathy as soon as one year following transplant. Pediatr Cardiol 2018; 39: 129–139.10.1007/s00246-017-1737-zCrossRefGoogle Scholar
Klauss, V, Ackermann, K, Spes, CH, et al. Coronary plaque morphologic charcteristics early and late after heart transplantation: in vivo analysis with intravascular ultrasound. Am Heart J 1997; 133: 29–35.10.1016/S0002-8703(97)70244-8CrossRefGoogle Scholar
Wong, CK, Yeung, AC. The topography of intimal thicknening and associated remodeling pattern of early transplant coronary disease: influence of pre-existent donor atherosclerosis. J Heart Lung Transplant 2001; 20: 858–864.CrossRefGoogle Scholar
Li, H, Tanaka, K, Oeser, B, Kobashigawa, JA, Tobis, JM. Vascular remodeling after cardiac transplantation: a 3-year serial intravascular ultrasound study. Eur Heart J 2006; 27: 1671–1677.CrossRefGoogle Scholar
Botas, J, Pinto, FJ, Chenzbraun, A, et al. Influence of preexistent donor coronary artery disease on the progression of transplant vasculopathy. An intravascular ultrasound study. Circulation 1995; 92: 1126–1132.10.1161/01.CIR.92.5.1126CrossRefGoogle ScholarPubMed
Kapadia, SR, Nissen, SE, Ziada, KM, et al. Development of transplantation vasculopathy and progression of donor-transmitted atherosclerosis: comparison by serial intravascular ultrasound imaging. Circulation 1998; 98: 2672–2678.CrossRefGoogle ScholarPubMed
Yamasaki, M, Sakurai, R, Hirohata, A, et al. Impact of donor-transmitted atherosclerosis on early cardiac allograft vasculopathy: new findings by three-dimensional intravascular ultrasound analysis. Transplantation 2011; 91: 1406–1411.10.1097/TP.0b013e31821ab91bCrossRefGoogle ScholarPubMed
Moayedi, Y, Fan, CPS, Tremblay-Gravel, M, et al. Risk factors for early development of cardiac allograft vasculopathy by intravascular ultrasound. Clin Transplant 2020; 34: e14098.CrossRefGoogle ScholarPubMed
National Institute of Organ, Tissue, Blood management.Guideline for management of organ transplantation. Retrieved January 13, 2021, from https://www.konos.go.kr/konosis/common/bizlogic.jsp.Google Scholar
Mintz, GS, Nissen, SE, Anderson, WD, et al. American college of cardiology clinical expert consensus document on standards for acquisition, measurement and reporting of intravascular ultrasound studies (ivus). A report of the american college of cardiology task force on clinical expert consensus documents. J Am Coll Cardiol 2001; 37: 1478–1492.CrossRefGoogle Scholar
Tuzcu, EM, Kapadia, SR, Tutar, E, et al. High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults: evidence from intravascular ultrasound. Circulation 2001; 103: 2705–2710.CrossRefGoogle Scholar
Kim, MS, Kang, SJ, Lee, CW, et al. Prevalence of coronary atherosclerosis in asymptomatic healthy subjects: an intravascular ultrasound study of donor hearts. J Atheroscler Thromb 2013; 20: 465–471.CrossRefGoogle ScholarPubMed
St Goar, FG, Pinto, FJ, Alderman, EL, et al. Detection of coronary atherosclerosis in young adult hearts using intravascular ultrasound. Circulation 1992; 86: 756–763.CrossRefGoogle ScholarPubMed
Lázaro, IJS, Bonet, LA, López, JM, et al. Inifluence of traditional cardiovascular risk factors in the recipient on the development of cardiac allograft vasculopathy after heart transplantation. Transplant Proc 2008; 40: 3056–3057.CrossRefGoogle Scholar
Jeewa, A, Dreyer, WJ, Kearney, DL, Denfield, SW. The presentation and diagnosis of coronary allograft vasculopathy in pediatric heart transplant recipients. Congenit Heart Dis 2012; 7: 302–311.CrossRefGoogle ScholarPubMed
Davis, SF, Yeung, AC, Meredith, IT, et al. Early endothelial dysfunction predicts the development of transplant coronary artery disease at 1 year posttransplant. Circulation 1996; 93: 457–462.CrossRefGoogle ScholarPubMed
Floré, V, Brown, AJ, Pettit, SJ, et al. Intravascular ultrasound of the proximal left anterior descending artery is sufficient to detect early cardiac allograft vasculopathy. Clin Transplant 2018; 32: e13167.CrossRefGoogle ScholarPubMed