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IMPACT OF MYOCARDIAL BRIDGING ON CORONARY ARTERY PLAQUE FORMATION AND LONG-TERM MORTALITY AFTER HEART TRANSPLANTATION
A1741 JACC March 17, 2015 Volume 65, Issue 10S
TCT@ACC-i2: Interventional Cardiology Impact of Myocardial Bridging on Coronary Artery Plaque Formation and LongTerm Mortality after Heart Transplantation Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: Coronary I Abstract Category: 36. TCT@ACC-i2: IVUS and Intravascular Physiology Presentation Number: 2100-302 Authors: Shigemitsu Tanaka, Kozo Okada, Hideki Kitahara, Yuhei Kobayashi, Helen Luikart, Paul Yock, Alan Yeung, Ingela Schnittger, Peter Fitzgerald, Kiran Khush, William Fearon, Yasuhiro Honda, Stanford University Medical Center, Stanford, CA, USA
Background: Myocardial bridging (MB) can cause both anatomic and functional coronary artery abnormalities, including accelerated proximal plaque development and endothelial dysfunction. This study aimed to explore the impact of MB on early development of cardiac allograft vasculopathy and long-term graft survival after heart transplantation. Methods: In 103 heart transplant recipients, serial (baseline and 1 year) volumetric IVUS was performed in the first 50 mm of the left anterior descending (LAD) artery. IVUS indices were evaluated in 3 equally divided LAD segments. MB was defined by IVUS as an echolucent muscular band surrounding the artery. The primary endpoint was death or re-transplantation, assessed for up to 12.2 years.
Results: IVUS identified MBs in 62% of the study population with similar clinical characteristics in MB vs. non-MB patients. At baseline, MB patients had smaller intimal volume in the distal LAD (p=0.002) than non-MB patients. During the first year, vessel volume decreased diffusely regardless of the presence of MB. MB patients demonstrated a significant increase in proximal plaque formation, while intimal growth in non-MB patients was distributed diffusely along the LAD artery (left figure). Kaplan-Meier analysis revealed significantly lower event-free survival in MB patients (hazard ratio=3.9, p=0.019. right figure). Conclusion: Presence of MB was associated with accelerated proximal intimal growth and reduced long-term survival after heart transplantation.
TCT@ACC-i2: Interventional Cardiology Impact of Myocardial Bridging on Coronary Artery Plaque Formation and LongTerm Mortality after Heart Transplantation Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: Coronary I Abstract Category: 36. TCT@ACC-i2: IVUS and Intravascular Physiology Presentation Number: 2100-302 Authors: Shigemitsu Tanaka, Kozo Okada, Hideki Kitahara, Yuhei Kobayashi, Helen Luikart, Paul Yock, Alan Yeung, Ingela Schnittger, Peter Fitzgerald, Kiran Khush, William Fearon, Yasuhiro Honda, Stanford University Medical Center, Stanford, CA, USA
Background: Myocardial bridging (MB) can cause both anatomic and functional coronary artery abnormalities, including accelerated proximal plaque development and endothelial dysfunction. This study aimed to explore the impact of MB on early development of cardiac allograft vasculopathy and long-term graft survival after heart transplantation. Methods: In 103 heart transplant recipients, serial (baseline and 1 year) volumetric IVUS was performed in the first 50 mm of the left anterior descending (LAD) artery. IVUS indices were evaluated in 3 equally divided LAD segments. MB was defined by IVUS as an echolucent muscular band surrounding the artery. The primary endpoint was death or re-transplantation, assessed for up to 12.2 years.
Results: IVUS identified MBs in 62% of the study population with similar clinical characteristics in MB vs. non-MB patients. At baseline, MB patients had smaller intimal volume in the distal LAD (p=0.002) than non-MB patients. During the first year, vessel volume decreased diffusely regardless of the presence of MB. MB patients demonstrated a significant increase in proximal plaque formation, while intimal growth in non-MB patients was distributed diffusely along the LAD artery (left figure). Kaplan-Meier analysis revealed significantly lower event-free survival in MB patients (hazard ratio=3.9, p=0.019. right figure). Conclusion: Presence of MB was associated with accelerated proximal intimal growth and reduced long-term survival after heart transplantation.