Relationship between markers of plaque vulnerability in optical coherence tomography and atherosclerotic progression in adult patients with heart transplantation

Kyoung Ha Park, Tao Sun, Zhi Liu, Shi Wei Yang, Ryan J. Lennon, Lilach O Lerman, Sudhir S. Kushwaha, Amir Lerman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease, and optical coherence tomography (OCT) provides detailed microstructural information. The current study was designed to test the hypothesis that markers of plaque vulnerability derived from OCT could predict CAV progression after heart transplantation (HTx). Methods: In 34 consecutive patients (median 3.1 years from HTx), intravascular ultrasound (IVUS) and OCT were performed in the left anterior descending artery (LAD) during routine annual coronary angiography. The presence of vulnerability markers, such as lipid pools, thin-cap fibroatheroma, macrophages and microchannels, was assessed in 100 consecutive frames of OCT in 20-mm segments of proximal LAD. The total number of appearances of vulnerable markers was defined as the vulnerability score (VS). Plaque volume (PV) was measured in the same study segment using IVUS at baseline and at 1-year follow-up, and the association between the baseline VS and the subsequent change in percent PV (PV / vessel volume × 100 [%PV]) was evaluated. Results: Follow-up IVUS study was conducted after 12.5 ± 1.3 months. The mean VS was 59.9 ± 44.6. Compared with the initial %PV, the follow-up %PV increased in the study segment (25.6 ± 13.7% to 31.8 ± 17.5%, . p <0.001). The correlations between baseline VS and δ%PV were significant in the study segment (r = 0.757, . p <0.001). On multivariable analysis, only the VS correlated significantly with δ%PV. Conclusions: Our results demonstrate that the markers of plaque vulnerability in OCT can predict the progression of CAV. Therefore, in patients with HTx, OCT may aid in determining prognosis and guiding therapy related to CAV.

Original languageEnglish (US)
JournalJournal of Heart and Lung Transplantation
DOIs
StateAccepted/In press - 2016

Fingerprint

Optical Coherence Tomography
Heart Transplantation
Allografts
Arteries
Atherosclerotic Plaques
Coronary Angiography
Coronary Artery Disease
Macrophages
Lipids

Keywords

  • Cardiac allograft vasculopathy
  • Heart transplantation
  • Intravascular ultrasound
  • Optical coherence tomography
  • Vulnerable plaque

ASJC Scopus subject areas

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

Cite this

@article{0ed31ade82f9409e9ce63822180a93c4,
title = "Relationship between markers of plaque vulnerability in optical coherence tomography and atherosclerotic progression in adult patients with heart transplantation",
abstract = "Background: Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease, and optical coherence tomography (OCT) provides detailed microstructural information. The current study was designed to test the hypothesis that markers of plaque vulnerability derived from OCT could predict CAV progression after heart transplantation (HTx). Methods: In 34 consecutive patients (median 3.1 years from HTx), intravascular ultrasound (IVUS) and OCT were performed in the left anterior descending artery (LAD) during routine annual coronary angiography. The presence of vulnerability markers, such as lipid pools, thin-cap fibroatheroma, macrophages and microchannels, was assessed in 100 consecutive frames of OCT in 20-mm segments of proximal LAD. The total number of appearances of vulnerable markers was defined as the vulnerability score (VS). Plaque volume (PV) was measured in the same study segment using IVUS at baseline and at 1-year follow-up, and the association between the baseline VS and the subsequent change in percent PV (PV / vessel volume × 100 [{\%}PV]) was evaluated. Results: Follow-up IVUS study was conducted after 12.5 ± 1.3 months. The mean VS was 59.9 ± 44.6. Compared with the initial {\%}PV, the follow-up {\%}PV increased in the study segment (25.6 ± 13.7{\%} to 31.8 ± 17.5{\%}, . p <0.001). The correlations between baseline VS and δ{\%}PV were significant in the study segment (r = 0.757, . p <0.001). On multivariable analysis, only the VS correlated significantly with δ{\%}PV. Conclusions: Our results demonstrate that the markers of plaque vulnerability in OCT can predict the progression of CAV. Therefore, in patients with HTx, OCT may aid in determining prognosis and guiding therapy related to CAV.",
keywords = "Cardiac allograft vasculopathy, Heart transplantation, Intravascular ultrasound, Optical coherence tomography, Vulnerable plaque",
author = "Park, {Kyoung Ha} and Tao Sun and Zhi Liu and Yang, {Shi Wei} and Lennon, {Ryan J.} and Lerman, {Lilach O} and Kushwaha, {Sudhir S.} and Amir Lerman",
year = "2016",
doi = "10.1016/j.healun.2016.06.004",
language = "English (US)",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Relationship between markers of plaque vulnerability in optical coherence tomography and atherosclerotic progression in adult patients with heart transplantation

AU - Park, Kyoung Ha

AU - Sun, Tao

AU - Liu, Zhi

AU - Yang, Shi Wei

AU - Lennon, Ryan J.

AU - Lerman, Lilach O

AU - Kushwaha, Sudhir S.

AU - Lerman, Amir

PY - 2016

Y1 - 2016

N2 - Background: Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease, and optical coherence tomography (OCT) provides detailed microstructural information. The current study was designed to test the hypothesis that markers of plaque vulnerability derived from OCT could predict CAV progression after heart transplantation (HTx). Methods: In 34 consecutive patients (median 3.1 years from HTx), intravascular ultrasound (IVUS) and OCT were performed in the left anterior descending artery (LAD) during routine annual coronary angiography. The presence of vulnerability markers, such as lipid pools, thin-cap fibroatheroma, macrophages and microchannels, was assessed in 100 consecutive frames of OCT in 20-mm segments of proximal LAD. The total number of appearances of vulnerable markers was defined as the vulnerability score (VS). Plaque volume (PV) was measured in the same study segment using IVUS at baseline and at 1-year follow-up, and the association between the baseline VS and the subsequent change in percent PV (PV / vessel volume × 100 [%PV]) was evaluated. Results: Follow-up IVUS study was conducted after 12.5 ± 1.3 months. The mean VS was 59.9 ± 44.6. Compared with the initial %PV, the follow-up %PV increased in the study segment (25.6 ± 13.7% to 31.8 ± 17.5%, . p <0.001). The correlations between baseline VS and δ%PV were significant in the study segment (r = 0.757, . p <0.001). On multivariable analysis, only the VS correlated significantly with δ%PV. Conclusions: Our results demonstrate that the markers of plaque vulnerability in OCT can predict the progression of CAV. Therefore, in patients with HTx, OCT may aid in determining prognosis and guiding therapy related to CAV.

AB - Background: Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease, and optical coherence tomography (OCT) provides detailed microstructural information. The current study was designed to test the hypothesis that markers of plaque vulnerability derived from OCT could predict CAV progression after heart transplantation (HTx). Methods: In 34 consecutive patients (median 3.1 years from HTx), intravascular ultrasound (IVUS) and OCT were performed in the left anterior descending artery (LAD) during routine annual coronary angiography. The presence of vulnerability markers, such as lipid pools, thin-cap fibroatheroma, macrophages and microchannels, was assessed in 100 consecutive frames of OCT in 20-mm segments of proximal LAD. The total number of appearances of vulnerable markers was defined as the vulnerability score (VS). Plaque volume (PV) was measured in the same study segment using IVUS at baseline and at 1-year follow-up, and the association between the baseline VS and the subsequent change in percent PV (PV / vessel volume × 100 [%PV]) was evaluated. Results: Follow-up IVUS study was conducted after 12.5 ± 1.3 months. The mean VS was 59.9 ± 44.6. Compared with the initial %PV, the follow-up %PV increased in the study segment (25.6 ± 13.7% to 31.8 ± 17.5%, . p <0.001). The correlations between baseline VS and δ%PV were significant in the study segment (r = 0.757, . p <0.001). On multivariable analysis, only the VS correlated significantly with δ%PV. Conclusions: Our results demonstrate that the markers of plaque vulnerability in OCT can predict the progression of CAV. Therefore, in patients with HTx, OCT may aid in determining prognosis and guiding therapy related to CAV.

KW - Cardiac allograft vasculopathy

KW - Heart transplantation

KW - Intravascular ultrasound

KW - Optical coherence tomography

KW - Vulnerable plaque

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U2 - 10.1016/j.healun.2016.06.004

DO - 10.1016/j.healun.2016.06.004

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JO - Journal of Heart and Lung Transplantation

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SN - 1053-2498

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