Volumetric remodeling of the proximal left coronary artery
Early versus late after heart transplantation1
Klaus Pethig, MDa,
Bernd Heublein, MD, FACCa,
Rolf R. Meliss, MDa and
Axel Haverich, MDa
a Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
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Figure 1 Graph demonstrating the procedure of volumetric quantification of cardiac allograft vasculopathy. Based on a motorized pullback, 16 equidistant cross-sectional sites were evaluated in the proximal left anterior descending artery.
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Figure 2 Reproducibility study for quantification of vessel (A) and lumen (B) volume, demonstrating a close correlation between the results of subsequent pullback maneuvers in the same vascular region.
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Figure 3 Individual changes in total vessel area in patients "early" (A) versus "late" (B) after heart transplantation.
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Figure 4 Cross-sectional examples of identical vascular sites in the left anterior descending artery 3.5 and 4.5 years after heart transplantation. Note compensatory enlargement of vascular cross-sectional area (characterized by the echolucent zone of the lamina elastica externa) maintaining a constant vessel lumen despite an increase in plaque mass.
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Figure 5 Bar graph demonstrating the significant decrease in mean vessel area, which is the most important factor responsible for the considerable luminal loss "early" after transplantation. In contrast changes "late" after heart transplantation are shown to be characterized by a mean increase in vessel volume, resulting in a slight increase in lumen volume. White bars = plaque volume; black bars = lumen volume; shaded bars = vessel volume. **p < 0.001.
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