Long‐Term Outcome After Heart Transplantation Predicted by Quantitative Myocardial Blush Grade in Coronary Angiography
The purpose of our study was to investigate whether the quantification of myocardial blush grade (MBG) during surveillance coronary angiography can predict long‐term outcome after heart transplantation (HT). In 105 HT recipients who underwent cardiac catheterization, cardiac allograft vasculopathy (...
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| Veröffentlicht in: | American journal of transplantation 2013-06, Vol.13 (6), p.1491-1502 |
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| creator | Hofmann, N. P. Voss, A. Dickhaus, H. Erbacher, M. Doesch, A. Ehlermann, P. Gitsioudis, G. Buss, S. J. Giannitsis, E. Katus, H. A. Korosoglou, G. |
| description | The purpose of our study was to investigate whether the quantification of myocardial blush grade (MBG) during surveillance coronary angiography can predict long‐term outcome after heart transplantation (HT). In 105 HT recipients who underwent cardiac catheterization, cardiac allograft vasculopathy (CAV) was assessed visually using the ISHLT grading scale (prospective cohort study). MBG was quantified by dividing the plateau of contrast agent gray‐level intensity (Gmax) by the time‐to‐peak intensity (Tmax). In a subgroup (n = 72), myocardial perfusion index by cardiac magnetic resonance imaging (CMR) was assessed. During a mean follow‐up duration of 2.7 (standard deviation [SD] 1.0) years, 26 patients experienced cardiac events, including 7 with cardiac death and 19 who underwent coronary revascularization. Gmax/Tmax was related to CAV by ISHLT criteria and to subsequent cardiac events. By univariate analysis, patient age, organ age, CAV, MBG and myocardial perfusion index by CMR were all predictive for cardiac events. Multivariable analysis demonstrated that Gmax/Tmax provided the most robust prediction of cardiac death (hazard ratio [HR] = 0.2, 95% confidence interval [CI] = 0.06–0.64, p |
| doi_str_mv | 10.1111/ajt.12223 |
| format | Article |
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Quantification of myocardial blush grade during surveillance coronary angiography aids the risk stratification of patients after heart transplantation by predicting all‐cause mortality, cardiac death, and coronary revascularisation procedures.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/ajt.12223</identifier><identifier>PMID: 23617734</identifier><language>eng</language><publisher>Hoboken, NJ: Wiley</publisher><subject>All‐cause mortality ; Biological and medical sciences ; Cardiac Catheterization ; cardiac death ; Cardiology ; Cardiovascular disease ; Cardiovascular system ; Confidence intervals ; Coronary Angiography - methods ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - mortality ; Coronary Artery Disease - therapy ; Coronary Circulation ; coronary revascularization ; Epidemiology ; Female ; Follow-Up Studies ; General aspects ; Germany - epidemiology ; Heart attacks ; Heart Failure - surgery ; heart transplantation ; Heart Transplantation - mortality ; Heart Transplantation - standards ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging, Cine ; Male ; Medical imaging ; Medical sciences ; Microcirculation ; Middle Aged ; Mortality ; Myocardial Revascularization ; Myocardium - pathology ; prognosis ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; quantitative myocardial blush grade ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survival Rate - trends ; Time Factors ; Transplantation, Homologous</subject><ispartof>American journal of transplantation, 2013-06, Vol.13 (6), p.1491-1502</ispartof><rights>Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons</rights><rights>2014 INIST-CNRS</rights><rights>Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4513-5dc96ec3b7d537326476ddb6ddb72f6e125d4a6c4c91f4e06b942ec7a3ed5e2d3</citedby><cites>FETCH-LOGICAL-c4513-5dc96ec3b7d537326476ddb6ddb72f6e125d4a6c4c91f4e06b942ec7a3ed5e2d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajt.12223$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajt.12223$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27512121$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23617734$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hofmann, N. P.</creatorcontrib><creatorcontrib>Voss, A.</creatorcontrib><creatorcontrib>Dickhaus, H.</creatorcontrib><creatorcontrib>Erbacher, M.</creatorcontrib><creatorcontrib>Doesch, A.</creatorcontrib><creatorcontrib>Ehlermann, P.</creatorcontrib><creatorcontrib>Gitsioudis, G.</creatorcontrib><creatorcontrib>Buss, S. J.</creatorcontrib><creatorcontrib>Giannitsis, E.</creatorcontrib><creatorcontrib>Katus, H. A.</creatorcontrib><creatorcontrib>Korosoglou, G.</creatorcontrib><title>Long‐Term Outcome After Heart Transplantation Predicted by Quantitative Myocardial Blush Grade in Coronary Angiography</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>The purpose of our study was to investigate whether the quantification of myocardial blush grade (MBG) during surveillance coronary angiography can predict long‐term outcome after heart transplantation (HT). In 105 HT recipients who underwent cardiac catheterization, cardiac allograft vasculopathy (CAV) was assessed visually using the ISHLT grading scale (prospective cohort study). MBG was quantified by dividing the plateau of contrast agent gray‐level intensity (Gmax) by the time‐to‐peak intensity (Tmax). In a subgroup (n = 72), myocardial perfusion index by cardiac magnetic resonance imaging (CMR) was assessed. During a mean follow‐up duration of 2.7 (standard deviation [SD] 1.0) years, 26 patients experienced cardiac events, including 7 with cardiac death and 19 who underwent coronary revascularization. Gmax/Tmax was related to CAV by ISHLT criteria and to subsequent cardiac events. By univariate analysis, patient age, organ age, CAV, MBG and myocardial perfusion index by CMR were all predictive for cardiac events. Multivariable analysis demonstrated that Gmax/Tmax provided the most robust prediction of cardiac death (hazard ratio [HR] = 0.2, 95% confidence interval [CI] = 0.06–0.64, p < 0.01) and cardiac events (HR = 0.52, 95% CI = 0.32–0.84, p < 0.01), beyond clinical parameters and the presence of CAV. Gmax/Tmax is a valuable surrogate parameter of microvascular integrity, which is associated with cardiac death and revascularization procedures after HT.
Quantification of myocardial blush grade during surveillance coronary angiography aids the risk stratification of patients after heart transplantation by predicting all‐cause mortality, cardiac death, and coronary revascularisation procedures.</description><subject>All‐cause mortality</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization</subject><subject>cardiac death</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular system</subject><subject>Confidence intervals</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary Circulation</subject><subject>coronary revascularization</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General aspects</subject><subject>Germany - epidemiology</subject><subject>Heart attacks</subject><subject>Heart Failure - surgery</subject><subject>heart transplantation</subject><subject>Heart Transplantation - mortality</subject><subject>Heart Transplantation - standards</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Microcirculation</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Revascularization</subject><subject>Myocardium - pathology</subject><subject>prognosis</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>quantitative myocardial blush grade</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Transplantation, Homologous</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0d1qFDEYBuBQlLZWD3oDJSBCPdg2_-kcrkttlZW2sB4PmeSbbZaZyZrMqHPmJXiNXolZd22hIJgQEpKHLyQvQseUnNHczs2qP6OMMb6HDqkiZKKo4M8e1lweoBcprQihml2wfXTAuKJac3GIvs9Dt_z14-cCYotvht6GFvC07iHiazCxx4tourRuTNeb3ocO30Zw3vbgcDXiuyHv-83JV8CfxmBNdN40-F0zpHt8FY0D7Ds8CzF0Jo542i19WEazvh9foue1aRK82s1H6PP7y8XsejK_ufowm84nVkjKJ9LZQoHllXaSa86U0Mq5ajM0qxVQJp0wygpb0FoAUVUhGFhtODgJzPEjdLqtu47hywCpL1ufLDT5RRCGVFKuGZGF4vw_qNSi0BeEZfr6CV2FIXb5IRulRMFVQbN6u1U2hpQi1OU6-jZ_RElJuUmuzMmVf5LL9mRXcahacA_yb1QZvNkBk6xp6pyL9enRaUlZ7tmdb90338D47xvL6cfF9urfNqiwZw</recordid><startdate>201306</startdate><enddate>201306</enddate><creator>Hofmann, N. P.</creator><creator>Voss, A.</creator><creator>Dickhaus, H.</creator><creator>Erbacher, M.</creator><creator>Doesch, A.</creator><creator>Ehlermann, P.</creator><creator>Gitsioudis, G.</creator><creator>Buss, S. J.</creator><creator>Giannitsis, E.</creator><creator>Katus, H. A.</creator><creator>Korosoglou, G.</creator><general>Wiley</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201306</creationdate><title>Long‐Term Outcome After Heart Transplantation Predicted by Quantitative Myocardial Blush Grade in Coronary Angiography</title><author>Hofmann, N. P. ; Voss, A. ; Dickhaus, H. ; Erbacher, M. ; Doesch, A. ; Ehlermann, P. ; Gitsioudis, G. ; Buss, S. J. ; Giannitsis, E. ; Katus, H. 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Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>quantitative myocardial blush grade</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hofmann, N. P.</creatorcontrib><creatorcontrib>Voss, A.</creatorcontrib><creatorcontrib>Dickhaus, H.</creatorcontrib><creatorcontrib>Erbacher, M.</creatorcontrib><creatorcontrib>Doesch, A.</creatorcontrib><creatorcontrib>Ehlermann, P.</creatorcontrib><creatorcontrib>Gitsioudis, G.</creatorcontrib><creatorcontrib>Buss, S. J.</creatorcontrib><creatorcontrib>Giannitsis, E.</creatorcontrib><creatorcontrib>Katus, H. 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P.</au><au>Voss, A.</au><au>Dickhaus, H.</au><au>Erbacher, M.</au><au>Doesch, A.</au><au>Ehlermann, P.</au><au>Gitsioudis, G.</au><au>Buss, S. J.</au><au>Giannitsis, E.</au><au>Katus, H. A.</au><au>Korosoglou, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long‐Term Outcome After Heart Transplantation Predicted by Quantitative Myocardial Blush Grade in Coronary Angiography</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2013-06</date><risdate>2013</risdate><volume>13</volume><issue>6</issue><spage>1491</spage><epage>1502</epage><pages>1491-1502</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>The purpose of our study was to investigate whether the quantification of myocardial blush grade (MBG) during surveillance coronary angiography can predict long‐term outcome after heart transplantation (HT). In 105 HT recipients who underwent cardiac catheterization, cardiac allograft vasculopathy (CAV) was assessed visually using the ISHLT grading scale (prospective cohort study). MBG was quantified by dividing the plateau of contrast agent gray‐level intensity (Gmax) by the time‐to‐peak intensity (Tmax). In a subgroup (n = 72), myocardial perfusion index by cardiac magnetic resonance imaging (CMR) was assessed. During a mean follow‐up duration of 2.7 (standard deviation [SD] 1.0) years, 26 patients experienced cardiac events, including 7 with cardiac death and 19 who underwent coronary revascularization. Gmax/Tmax was related to CAV by ISHLT criteria and to subsequent cardiac events. By univariate analysis, patient age, organ age, CAV, MBG and myocardial perfusion index by CMR were all predictive for cardiac events. Multivariable analysis demonstrated that Gmax/Tmax provided the most robust prediction of cardiac death (hazard ratio [HR] = 0.2, 95% confidence interval [CI] = 0.06–0.64, p < 0.01) and cardiac events (HR = 0.52, 95% CI = 0.32–0.84, p < 0.01), beyond clinical parameters and the presence of CAV. Gmax/Tmax is a valuable surrogate parameter of microvascular integrity, which is associated with cardiac death and revascularization procedures after HT.
Quantification of myocardial blush grade during surveillance coronary angiography aids the risk stratification of patients after heart transplantation by predicting all‐cause mortality, cardiac death, and coronary revascularisation procedures.</abstract><cop>Hoboken, NJ</cop><pub>Wiley</pub><pmid>23617734</pmid><doi>10.1111/ajt.12223</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | All‐cause mortality Biological and medical sciences Cardiac Catheterization cardiac death Cardiology Cardiovascular disease Cardiovascular system Confidence intervals Coronary Angiography - methods Coronary Artery Disease - diagnosis Coronary Artery Disease - mortality Coronary Artery Disease - therapy Coronary Circulation coronary revascularization Epidemiology Female Follow-Up Studies General aspects Germany - epidemiology Heart attacks Heart Failure - surgery heart transplantation Heart Transplantation - mortality Heart Transplantation - standards Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging, Cine Male Medical imaging Medical sciences Microcirculation Middle Aged Mortality Myocardial Revascularization Myocardium - pathology prognosis Public health. Hygiene Public health. Hygiene-occupational medicine quantitative myocardial blush grade Radiodiagnosis. Nmr imagery. Nmr spectrometry Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Survival Rate - trends Time Factors Transplantation, Homologous |
| title | Long‐Term Outcome After Heart Transplantation Predicted by Quantitative Myocardial Blush Grade in Coronary Angiography |
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