Scientists have proven the prognostic value of intravascular ultrasound » Medvestnik


Scientists have proven the prognostic significance of intravascular ultrasound of the heart for assessing long-term outcomes after heart transplantation. The optimal threshold value that correlates with all-cause mortality is the volume of atheromatous plaques equal to 7%.

Scientists from Stanford University School of Medicine, the University of Oslo, and Sahlgrenska University Hospital assessed long-term outcomes of heart transplantation using intravascular ultrasound and atheromatous plaque volume as a parameter of cardiac allograft vasculopathy. The study results were published in the European Heart Journal.

Patients with a percentage increase in atheromatous plaque volume of 7% or more had significantly higher mortality (34%) than those with a percentage increase in atheromatous plaque volume of less than 7% (14%). The incidence of major adverse cardiovascular events, predominantly fatal, was significantly higher in the group of participants with a percentage increase in atheromatous plaque volume of 7% or more than in those with a smaller increase: 40% versus 21%.




The study included 243 patients aged 18 to 70 years from four transplant centers. The average relative volume of atheromatous plaques at baseline, in the first year, and the increase in the first year were 19.5, 23.5, and 4%, respectively. The mean follow-up time to determine all-cause mortality reached 8.1 years.

There were 44 deaths and two cases of re-transplantation. Cardiovascular deaths were detected in 35 participants. Percutaneous coronary intervention or coronary artery bypass grafting was performed in 10 patients, and heart failure was diagnosed in 32 patients (ejection fraction <45%).

The mean increase in atheromatous plaque volume was significantly greater among nonsurvivors than among survivors. A percentage increase in atheromatous plaque volume of 7% or more was found to be optimal for predicting all-cause mortality.



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