TY - EJOU
AU - Cote, Anita T.
AU - Hosking, Martin
AU - Voss, Christine
AU - Human, Derek G.
AU - Sandor, George G. S.
AU - Harris, Kevin C.
TI - Coronary artery intimal thickening and ventricular dynamics in pediatric heart transplant recipients
T2 - Congenital Heart Disease
PY - 2018
VL - 13
IS - 5
SN - 1747-0803
AB - Objective: Pediatric heart transplant recipients are at risk of posttransplant coronary
artery disease known as cardiac allograft vasculopathy (CAV), and also may develop
diastolic dysfunction. As CAV begins with a process of progressive intimal thickening,
these occult diffuse changes may be detected using optical coherence tomography
(OCT). We hypothesized that the development of CAV, as identified via OCT, may be
a mechanism of declining ventricular function. Accordingly, the purpose of this study
was to assess coronary artery intimal thickening and LV strain in children who have
undergone heart transplantation.
Methods: In 17 children, we analyzed OCT images for coronary intima and media
thickness, and cross‐sectional area (CSA). We also performed speckle tracking imag‐
ing (STI) of the LV to determine longitudinal strain and strain rate, in addition to
standard echocardiographic measures.
Results: Longitudinal diastolic strain rate was associated with maximum intima thick‐
ness (r = −.497, P = .042), intima CSA, (r = −.489, P = .047), maximum media thickness
(r = −.503, P = .039), and media CSA (r = −.614, P = .009). The intima maximum thick‐
ness, intima/media, and intima/lumen ratios were associated with stroke volume
index (Std. β = −0.487, P = .023 and Std. β = −0.488, P = .022, respectively).
Conclusions: These findings suggest coronary artery intimal thickening may be
mechanistically linked to changes in ventricular function following cardiac
transplantation.
KW - coronary artery
KW - heart transplantation
KW - left ventricular strain
DO - 10.1111/chd.12629