@Article{chd.12629,
AUTHOR = {Anita T. Cote, Martin Hosking, Christine Voss, Derek G. Human, George G. S. Sandor, Kevin C. Harris},
TITLE = {Coronary artery intimal thickening and ventricular dynamics in  pediatric heart transplant recipients},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {5},
PAGES = {663--670},
URL = {http://www.techscience.com/schd/v13n5/39044},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> 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.<br/>
<b>Methods:</b> 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.<br/>
<b>Results:</b> 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).<br/>
<b>Conclusions:</b> These findings suggest coronary artery intimal thickening may be 
mechanistically linked to changes in ventricular function following cardiac 
transplantation.},
DOI = {10.1111/chd.12629}
}