Kardiologia polska · 2025
Prognostic value of angiography-based fractional flow reserve of left anterior descending artery in orthotopic heart transplant recipients.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bujak Kamil, Kuczaj Agnieszka, Liszka Radosław, Skulik Przemysław, Konsek Karolina, Hrapkowicz Tomasz, Gąsior Mariusz, Przybyłowski Piotr
Аннотация
BACKGROUND: Coronary angiography has limited value in predicting subsequent events in cases of no or mild cardiac allograft vasculopathy (CAV). We aimed to assess the prognostic value of angiography-based vessel fractional flow reserve (vFFR) in orthotopic heart transplant recipients.
MATERIAL AND METHODS: The study retrospectively included patients who underwent baseline coronary angiography after orthotopic heart transplant between 2014 and 2023 and had no obstructive CAV. The vFFR computation was performed for three major vessels. Patients were stratified into groups of vFFR of <0.90 and ≥0.90. The primary endpoint was the composite of death, retransplantation, and unplanned revascularization.
RESULTS: 258 patients with coronary angiograms feasible for vFFR assessment of at least one vessel were included. There was no difference in baseline characteristics, laboratory findings, history of graft rejection, or medical treatment, except for older donor age and a higher rate of donor/recipient sex mismatch in patients with a lower vFFR of the left anterior descending artery (LAD) compared to those with a vFFR of ≥0.90. Patients with a vFFR of the LAD of <0.90 also significantly more often had a CAV grade of 1. At 8 years, LAD vFFR of <0.90 was associated with a higher risk of the primary endpoint (adjusted HR, 2.72; 95% CI, 1.03-7.17; P = 0.04). There was no association between vFFR of the circumflex or right coronary artery and clinical outcomes.
CONCLUSION: In patients with LAD vFFR <0.90, there was a higher risk of the composite endpoint of death, retransplantation, and unplanned revascularization than in patients with LAD vFFR ≥0.90.
MATERIAL AND METHODS: The study retrospectively included patients who underwent baseline coronary angiography after orthotopic heart transplant between 2014 and 2023 and had no obstructive CAV. The vFFR computation was performed for three major vessels. Patients were stratified into groups of vFFR of <0.90 and ≥0.90. The primary endpoint was the composite of death, retransplantation, and unplanned revascularization.
RESULTS: 258 patients with coronary angiograms feasible for vFFR assessment of at least one vessel were included. There was no difference in baseline characteristics, laboratory findings, history of graft rejection, or medical treatment, except for older donor age and a higher rate of donor/recipient sex mismatch in patients with a lower vFFR of the left anterior descending artery (LAD) compared to those with a vFFR of ≥0.90. Patients with a vFFR of the LAD of <0.90 also significantly more often had a CAV grade of 1. At 8 years, LAD vFFR of <0.90 was associated with a higher risk of the primary endpoint (adjusted HR, 2.72; 95% CI, 1.03-7.17; P = 0.04). There was no association between vFFR of the circumflex or right coronary artery and clinical outcomes.
CONCLUSION: In patients with LAD vFFR <0.90, there was a higher risk of the composite endpoint of death, retransplantation, and unplanned revascularization than in patients with LAD vFFR ≥0.90.