Decreased Coronary Flow Reserve Measured with Doppler Flow Wire Technique Was Associated with Stenotic Myocardial Microvasculopathy in Pediatric Patients after Heart Transplantation

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• 作者：H. Ide¹ ; T. Ueno¹ ; S. Kogaki² ; N. Fukushima¹ ; Y. Sawa¹
• 刊名：The Journal of Heart and Lung Transplantation
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：32
• 期：4_supp_S
• 页码：S239
• 全文大小：84 K

文摘

Purpose

Stenotic myocardial microvasculopathy (MVP) has been shown to impact the long term survival after heart transplantation (HTx). We hypothesized that Coronary Flow Reserve (CFR) measured with doppler flow wire technique might be correlated with histologically defined stenotic MVP after HTx in pediatric population.

Methods and Materials

Between January 2000 and November 2012, patients aged < 18 years at the time of HTx, who had at least one session of CFR measurement at the time of annual endomyocardial biopsy (EBM) at our institute, were enrolled. Patients died during the first 30 days after HTx were excluded. Stenotic MVP was identified with light microscopy (¡Á200) evaluations, defined as stenotic endothelial and/or medial changes of microvessels (diameter 10 to 20¦Ìm). Patients were divided in two groups; stenotic and non stenotic MVP. CFR were compared between those groups.

Results

25 patients (male: 12, average month at HTx, 108¡À79 months) underwent 127 EBM (average duration after HTx, 52 ¡À35 months). Of those CFR was measured concomitantly in 71 studies. Average CFR was 2.1 ¡À 1.4. Of 71 specimens, 36 were defined as stenotic. CFR was significantly lower in stenotic group compared with non stenotic group (1.5 ¡À 0.3 versus 2.7 ¡À0.8; P=0.041).

Conclusions

Coronary Flow Reserve measured with DFW might be effective in clarifying the myocardial microvasculopathy in patients after pediatric HTx.