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Prognostic value of...
Prognostic value of comprehensive intracoronary physiology assessment early after heart transplantation.
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Ahn, Jung-Min (author)
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Zimmermann, Frederik M (author)
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Arora, Satish (author)
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Solberg, Ole-Geir (author)
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- Angerås, Oskar, 1976 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Rolid, Katrine (author)
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Rafique, Muzammil (author)
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Aaberge, Lars (author)
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- Karason, Kristjan, 1962 (author)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Wallenberg Laboratory,Institute of Medicine, Department of Molecular and Clinical Medicine
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Okada, Kozo (author)
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Luikart, Helen (author)
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Khush, Kiran K (author)
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Honda, Yasuhiro (author)
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Pijls, Nico H J (author)
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Lee, Sang Eun (author)
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Kim, Jae-Joong (author)
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Park, Seung-Jung (author)
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Gullestad, Lars (author)
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Fearon, William F (author)
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(creator_code:org_t)
- 2021-10-19
- 2021
- English.
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In: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 42:48, s. 4918-4929
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https://academic.oup...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- We evaluated the long-term prognostic value of invasively assessing coronary physiology after heart transplantation in a large multicentre registry.Comprehensive intracoronary physiology assessment measuring fractional flow reserve (FFR), the index of microcirculatory resistance (IMR), and coronary flow reserve (CFR) was performed in 254 patients at baseline (a median of 7.2weeks) and in 240 patients at 1year after transplantation (199 patients had both baseline and 1-year measurement). Patients were classified into those with normal physiology, reduced FFR (FFR≤0.80), and microvascular dysfunction (either IMR≥25 or CFR≤2.0 with FFR>0.80). The primary outcome was the composite of death or re-transplantation at 10years. At baseline, 5.5% had reduced FFR; 36.6% had microvascular dysfunction. Baseline reduced FFR [adjusted hazard ratio (aHR) 2.33, 95% confidence interval (CI) 0.88-6.15; P=0.088] and microvascular dysfunction (aHR 0.88, 95% CI 0.44-1.79; P=0.73) were not predictors of death and re-transplantation at 10years. At 1year, 5.0% had reduced FFR; 23.8% had microvascular dysfunction. One-year reduced FFR (aHR 2.98, 95% CI 1.13-7.87; P=0.028) and microvascular dysfunction (aHR 2.33, 95% CI 1.19-4.59; P=0.015) were associated with significantly increased risk of death or re-transplantation at 10years. Invasive measures of coronary physiology improved the prognostic performance of clinical variables (χ2 improvement: 7.41, P=0.006). However, intravascular ultrasound-derived changes in maximal intimal thickness were not predictive of outcomes.Abnormal coronary physiology 1year after heart transplantation was common and was a significant predictor of death or re-transplantation at 10years.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Cardiac allograft vasculopathy
- Coronary stenosis
- Heart transplantation
- Microvascular dysfunction
- Prognosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ahn, Jung-Min
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Zimmermann, Fred ...
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Arora, Satish
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Solberg, Ole-Gei ...
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Angerås, Oskar, ...
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Rolid, Katrine
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show more...
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Rafique, Muzammi ...
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Aaberge, Lars
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Karason, Kristja ...
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Okada, Kozo
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Luikart, Helen
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Khush, Kiran K
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Honda, Yasuhiro
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Pijls, Nico H J
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Lee, Sang Eun
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Kim, Jae-Joong
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Park, Seung-Jung
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Gullestad, Lars
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Fearon, William ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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European heart j ...
- By the university
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University of Gothenburg