Assessment and Characterization of Time-related Differences in Plaque Composition by Intravascular Ultrasound–derived Radiofrequency Analysis in Heart Transplant Recipients

König, Andreas; Kilian, Eckehard; Sohn, Hae-Young; Rieber, Johannes; Schiele, Thomas Michael; Siebert, Uwe; Gothe, Raffaella M.; Reichart, Bruno; Klauss, Volker

doi:10.1016/j.healun.2007.12.003

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 27, Issue 3 , Pages 302-309, March 2008

Assessment and Characterization of Time-related Differences in Plaque Composition by Intravascular Ultrasound–derived Radiofrequency Analysis in Heart Transplant Recipients

Andreas König, MD
- Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik–Innenstadt, Munich, Germany
- Reprint requests: Andreas König, MD, Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik-Innenstadt, Ludwig-Maximilians-Universität, Ziemssenstrasse 1, 80336 Munich, Germany. Telephone: 0049-89-5160-7670. Fax: 0049-89-5160-2152.
Eckehard Kilian, MD
- Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
Hae-Young Sohn, MD
- Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik–Innenstadt, Munich, Germany
Johannes Rieber, MD
- Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik–Innenstadt, Munich, Germany
Thomas Michael Schiele, MD
- Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik–Innenstadt, Munich, Germany
Uwe Siebert, MD, MPH
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, Hall, Austria
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Raffaella M. Gothe
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, Hall, Austria
Bruno Reichart, MD
- Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
Volker Klauss, MD
- Department of Medicine, Division of Cardiology, Medizinische Klinik und Poliklinik–Innenstadt, Munich, Germany

Received 21 September 2007; received in revised form 5 December 2007; accepted 14 December 2007.

Background

The survival of heart transplant patients is limited by cardiac allograft vasculopathy (CAV). Intravascular ultrasound (IVUS) and IVUS-derived radiofrequency plaque composition analysis (IVUS-RF) provide further information about the process of coronary atherosclerosis.

Methods

In this study we aimed to assess the time-dependent differences in disease progression in patients with CAV. Fifty-six patients were divided into three groups according to time interval after transplantation (Group I: 1 to 3 months, 18 patients; Group II, 1 to 5 years, 20 patients; Group III: 5 to 15 years, 18 patients).

Results

IVUS-RF revealed time-dependent increases in all plaque components. The largest increase was shown for fibrotic, fibrofatty and necrotic tissue between Groups I and II. Dense calcium area increased uniformly in all groups. IVUS-RF–derived plaque type analysis revealed predominantly fibrotic plaques in all groups with a decrease of frequency over time. Fibrolipidic and fibrotic–calcific plaques increased uniformly. High-risk lesions, such as thick-cap fibroatheromas (FAs), increased in Groups I and II and decreased in Group III. Thin-cap FAs were detected only in Group III.

Conclusions

IVUS-RF, as compared with gray-scale IVUS, provides better detailed information about the development of CAV by plaque morphology and composition analysis in different stages after heart transplantation. Serial IVUS-RF analysis in these patients may improve the stratification of heart transplant recipients.