Coronary Angiography for Follow-up of Heart Transplant Recipients: Insights From TIMI Frame Count and TIMI Myocardial Perfusion Grade

Nezihi Baris, Ilke Sipahi, Samir R. Kapadia, Stephen J. Nicholls, Kursad Erinc, Okan Gulel, Timothy D. Crowe, Robert Hobbs, Mohamad H. Yamani, David O. Taylor, Nicolas Smedira, Randall C. Starling, Steven E. Nissen, E. Murat Tuzcu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The aim of this study was to evaluate the course of Thrombolysis in Myocardial Infarction (TIMI) frame count (TIMI FC) and myocardial perfusion grade (TIMI MPG) in heart transplant recipients and whether these parameters could predict mortality. Methods: Sixty-two heart transplant recipients were enrolled in this study. All patients had coronary angiography at baseline and at 1 year, which were evaluated for TIMI FC and TIMI MPG. Also, 50 vessels in 35 patients were analyzed with volumetric intravascular ultrasound (IVUS) at baseline and at 1 year. Rejection episodes and mortality were recorded during the follow-up period. Results: The mean follow-up interval was 51.5 ± 17.2 months (range 12.2 to 78.4 months). TIMI FCs of all three coronary arteries and global TIMI FC (gTIMI FC) significantly increased from baseline during the first year (p < 0.0001). TIMI MPG deteriorated significantly (p < 0.0001 for left anterior descending and circumflex coronary arteries, p = 0.002 for right coronary artery). There was no correlation between changes in TIMI FC and progression of transplant vasculopathy as assessed by IVUS. Episodes of Grade ≥3A rejection were significantly more frequent in the stable gTIMI FC group (p = 0.03). Mortality rate was significantly higher in the group with increasing gTFC (p = 0.02). Conclusions: gTIMI FCs and TIMI FCs of coronary arteries increase, and TIMI MPG gradually deteriorates during the first year after transplantation. Mortality rate is significantly higher in patients whose gTIMI FC increases from baseline. Change in gTIMI FC is a simple quantitative predictor of long-term mortality in heart transplant recipients.

Original languageEnglish (US)
Pages (from-to)593-597
Number of pages5
JournalJournal of Heart and Lung Transplantation
Volume26
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

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Coronary Angiography
Perfusion
Myocardial Infarction
Coronary Vessels
Mortality
Transplant Recipients
Transplantation
Transplants

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Coronary Angiography for Follow-up of Heart Transplant Recipients : Insights From TIMI Frame Count and TIMI Myocardial Perfusion Grade. / Baris, Nezihi; Sipahi, Ilke; Kapadia, Samir R.; Nicholls, Stephen J.; Erinc, Kursad; Gulel, Okan; Crowe, Timothy D.; Hobbs, Robert; Yamani, Mohamad H.; Taylor, David O.; Smedira, Nicolas; Starling, Randall C.; Nissen, Steven E.; Tuzcu, E. Murat.

In: Journal of Heart and Lung Transplantation, Vol. 26, No. 6, 06.2007, p. 593-597.

Research output: Contribution to journalArticle

Baris, N, Sipahi, I, Kapadia, SR, Nicholls, SJ, Erinc, K, Gulel, O, Crowe, TD, Hobbs, R, Yamani, MH, Taylor, DO, Smedira, N, Starling, RC, Nissen, SE & Tuzcu, EM 2007, 'Coronary Angiography for Follow-up of Heart Transplant Recipients: Insights From TIMI Frame Count and TIMI Myocardial Perfusion Grade', Journal of Heart and Lung Transplantation, vol. 26, no. 6, pp. 593-597. https://doi.org/10.1016/j.healun.2007.03.016
Baris, Nezihi ; Sipahi, Ilke ; Kapadia, Samir R. ; Nicholls, Stephen J. ; Erinc, Kursad ; Gulel, Okan ; Crowe, Timothy D. ; Hobbs, Robert ; Yamani, Mohamad H. ; Taylor, David O. ; Smedira, Nicolas ; Starling, Randall C. ; Nissen, Steven E. ; Tuzcu, E. Murat. / Coronary Angiography for Follow-up of Heart Transplant Recipients : Insights From TIMI Frame Count and TIMI Myocardial Perfusion Grade. In: Journal of Heart and Lung Transplantation. 2007 ; Vol. 26, No. 6. pp. 593-597.
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abstract = "Background: The aim of this study was to evaluate the course of Thrombolysis in Myocardial Infarction (TIMI) frame count (TIMI FC) and myocardial perfusion grade (TIMI MPG) in heart transplant recipients and whether these parameters could predict mortality. Methods: Sixty-two heart transplant recipients were enrolled in this study. All patients had coronary angiography at baseline and at 1 year, which were evaluated for TIMI FC and TIMI MPG. Also, 50 vessels in 35 patients were analyzed with volumetric intravascular ultrasound (IVUS) at baseline and at 1 year. Rejection episodes and mortality were recorded during the follow-up period. Results: The mean follow-up interval was 51.5 ± 17.2 months (range 12.2 to 78.4 months). TIMI FCs of all three coronary arteries and global TIMI FC (gTIMI FC) significantly increased from baseline during the first year (p < 0.0001). TIMI MPG deteriorated significantly (p < 0.0001 for left anterior descending and circumflex coronary arteries, p = 0.002 for right coronary artery). There was no correlation between changes in TIMI FC and progression of transplant vasculopathy as assessed by IVUS. Episodes of Grade ≥3A rejection were significantly more frequent in the stable gTIMI FC group (p = 0.03). Mortality rate was significantly higher in the group with increasing gTFC (p = 0.02). Conclusions: gTIMI FCs and TIMI FCs of coronary arteries increase, and TIMI MPG gradually deteriorates during the first year after transplantation. Mortality rate is significantly higher in patients whose gTIMI FC increases from baseline. Change in gTIMI FC is a simple quantitative predictor of long-term mortality in heart transplant recipients.",
author = "Nezihi Baris and Ilke Sipahi and Kapadia, {Samir R.} and Nicholls, {Stephen J.} and Kursad Erinc and Okan Gulel and Crowe, {Timothy D.} and Robert Hobbs and Yamani, {Mohamad H.} and Taylor, {David O.} and Nicolas Smedira and Starling, {Randall C.} and Nissen, {Steven E.} and Tuzcu, {E. Murat}",
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T1 - Coronary Angiography for Follow-up of Heart Transplant Recipients

T2 - Insights From TIMI Frame Count and TIMI Myocardial Perfusion Grade

AU - Baris, Nezihi

AU - Sipahi, Ilke

AU - Kapadia, Samir R.

AU - Nicholls, Stephen J.

AU - Erinc, Kursad

AU - Gulel, Okan

AU - Crowe, Timothy D.

AU - Hobbs, Robert

AU - Yamani, Mohamad H.

AU - Taylor, David O.

AU - Smedira, Nicolas

AU - Starling, Randall C.

AU - Nissen, Steven E.

AU - Tuzcu, E. Murat

PY - 2007/6

Y1 - 2007/6

N2 - Background: The aim of this study was to evaluate the course of Thrombolysis in Myocardial Infarction (TIMI) frame count (TIMI FC) and myocardial perfusion grade (TIMI MPG) in heart transplant recipients and whether these parameters could predict mortality. Methods: Sixty-two heart transplant recipients were enrolled in this study. All patients had coronary angiography at baseline and at 1 year, which were evaluated for TIMI FC and TIMI MPG. Also, 50 vessels in 35 patients were analyzed with volumetric intravascular ultrasound (IVUS) at baseline and at 1 year. Rejection episodes and mortality were recorded during the follow-up period. Results: The mean follow-up interval was 51.5 ± 17.2 months (range 12.2 to 78.4 months). TIMI FCs of all three coronary arteries and global TIMI FC (gTIMI FC) significantly increased from baseline during the first year (p < 0.0001). TIMI MPG deteriorated significantly (p < 0.0001 for left anterior descending and circumflex coronary arteries, p = 0.002 for right coronary artery). There was no correlation between changes in TIMI FC and progression of transplant vasculopathy as assessed by IVUS. Episodes of Grade ≥3A rejection were significantly more frequent in the stable gTIMI FC group (p = 0.03). Mortality rate was significantly higher in the group with increasing gTFC (p = 0.02). Conclusions: gTIMI FCs and TIMI FCs of coronary arteries increase, and TIMI MPG gradually deteriorates during the first year after transplantation. Mortality rate is significantly higher in patients whose gTIMI FC increases from baseline. Change in gTIMI FC is a simple quantitative predictor of long-term mortality in heart transplant recipients.

AB - Background: The aim of this study was to evaluate the course of Thrombolysis in Myocardial Infarction (TIMI) frame count (TIMI FC) and myocardial perfusion grade (TIMI MPG) in heart transplant recipients and whether these parameters could predict mortality. Methods: Sixty-two heart transplant recipients were enrolled in this study. All patients had coronary angiography at baseline and at 1 year, which were evaluated for TIMI FC and TIMI MPG. Also, 50 vessels in 35 patients were analyzed with volumetric intravascular ultrasound (IVUS) at baseline and at 1 year. Rejection episodes and mortality were recorded during the follow-up period. Results: The mean follow-up interval was 51.5 ± 17.2 months (range 12.2 to 78.4 months). TIMI FCs of all three coronary arteries and global TIMI FC (gTIMI FC) significantly increased from baseline during the first year (p < 0.0001). TIMI MPG deteriorated significantly (p < 0.0001 for left anterior descending and circumflex coronary arteries, p = 0.002 for right coronary artery). There was no correlation between changes in TIMI FC and progression of transplant vasculopathy as assessed by IVUS. Episodes of Grade ≥3A rejection were significantly more frequent in the stable gTIMI FC group (p = 0.03). Mortality rate was significantly higher in the group with increasing gTFC (p = 0.02). Conclusions: gTIMI FCs and TIMI FCs of coronary arteries increase, and TIMI MPG gradually deteriorates during the first year after transplantation. Mortality rate is significantly higher in patients whose gTIMI FC increases from baseline. Change in gTIMI FC is a simple quantitative predictor of long-term mortality in heart transplant recipients.

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