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THE COMPARISON BETWEEN CARDIAC ALLOGRAFT VASCULOPATHY AND ATHEROSCLEROSIS DETECTED BY NEAR-INFRARED SPECTROSCOPY
A1801 JACC April 1, 2014 Volume 63, Issue 12
TCT@ACC-i2: The Interventional Learning Pathway The Comparison Between Cardiac Allograft Vasculopathy and Atherosclerosis Detected by Near-Infrared Spectroscopy Poster Contributions Hall C Saturday, March 29, 2014, 3:45 p.m.-4:30 p.m.
Session Title: IVUS and Physiology Abstract Category: 35. TCT@ACC-i2: IVUS and Intravascular Physiology Presentation Number: 2103-317 Authors: Bo Zheng, Akiko Maehara, Gary Mintz, Tamim Nazif, Yarden Wachsman, Luz Jaquez, Leroy Rabbani, Mark Apfelbaum, Ziad Ali, Kate Dalton, Donna Mancini, Giora Weisz, Cardiovascular Research Foundation, New York, NY, USA, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA Background: Cardiac Allograft Vasculopathy (CAV) is a major cause of morbidity and mortality in transplant pts. Both intimal proliferation and atherosclerosis have been attributed to the pathophysiology of CAV. Methods: We compared IVUS and Near-Infrared Spectroscopy (NIRS) findings in 25 heart transplant recipients and 34 common atherosclerosis pts - matched for age, gender, and diabetes. Lipid core burden index (LCBI) was calculated as pixels with a probability of lipid rich plaque (LRP) >0.6 divided by all viable pixels. In each proximal, middle, and distal coronary artery segment, the maxLCBI4mm (4mm long segment with maximum LCBI) and corresponding plaque burden by IVUS were compared. Result: As compared to CAV pts, atherosclerosis pts had larger, more eccentric plaque burden ,smaller lumen areas and higher the maxLCBI4mm in all 3 coronary segments. LRP was not observed in atherosclerosis pts until plaque burden exceeded 40% (Panel A). Conversely, LRP was seen in CAV pts with minimal plaque burden (Panel B). In lesions with mild plaque burden of <40%, maxLCBI4mm was significantly greater in CAV pts as compared to control group (62±116 vs 6±11, p=0.001); however, in lesions with plaque burden ≥40%, maxLCBI4mm in was similar to atherosclerosis pts (202±202 vs 232±188, p=0.53). Conclusion: These findings indicate that low-burden plaque is more lipid rich in CAV patients as compared to common atherosclerosis. The development of lipid rich plaque may represent the early stage of the development of CAV.
TCT@ACC-i2: The Interventional Learning Pathway The Comparison Between Cardiac Allograft Vasculopathy and Atherosclerosis Detected by Near-Infrared Spectroscopy Poster Contributions Hall C Saturday, March 29, 2014, 3:45 p.m.-4:30 p.m.
Session Title: IVUS and Physiology Abstract Category: 35. TCT@ACC-i2: IVUS and Intravascular Physiology Presentation Number: 2103-317 Authors: Bo Zheng, Akiko Maehara, Gary Mintz, Tamim Nazif, Yarden Wachsman, Luz Jaquez, Leroy Rabbani, Mark Apfelbaum, Ziad Ali, Kate Dalton, Donna Mancini, Giora Weisz, Cardiovascular Research Foundation, New York, NY, USA, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA Background: Cardiac Allograft Vasculopathy (CAV) is a major cause of morbidity and mortality in transplant pts. Both intimal proliferation and atherosclerosis have been attributed to the pathophysiology of CAV. Methods: We compared IVUS and Near-Infrared Spectroscopy (NIRS) findings in 25 heart transplant recipients and 34 common atherosclerosis pts - matched for age, gender, and diabetes. Lipid core burden index (LCBI) was calculated as pixels with a probability of lipid rich plaque (LRP) >0.6 divided by all viable pixels. In each proximal, middle, and distal coronary artery segment, the maxLCBI4mm (4mm long segment with maximum LCBI) and corresponding plaque burden by IVUS were compared. Result: As compared to CAV pts, atherosclerosis pts had larger, more eccentric plaque burden ,smaller lumen areas and higher the maxLCBI4mm in all 3 coronary segments. LRP was not observed in atherosclerosis pts until plaque burden exceeded 40% (Panel A). Conversely, LRP was seen in CAV pts with minimal plaque burden (Panel B). In lesions with mild plaque burden of <40%, maxLCBI4mm was significantly greater in CAV pts as compared to control group (62±116 vs 6±11, p=0.001); however, in lesions with plaque burden ≥40%, maxLCBI4mm in was similar to atherosclerosis pts (202±202 vs 232±188, p=0.53). Conclusion: These findings indicate that low-burden plaque is more lipid rich in CAV patients as compared to common atherosclerosis. The development of lipid rich plaque may represent the early stage of the development of CAV.