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Quantitative coronary computed tomography angiography for the detection of cardiac allograft vasculopathy.

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Title: Quantitative coronary computed tomography angiography for the detection of cardiac allograft vasculopathy.
Authors: Foldyna, Borek1,2,3 (AUTHOR) bfoldyna@mgh.harvard.edu, Sandri, Marcus4 (AUTHOR), Luecke, Christian1 (AUTHOR), Garbade, Jens5 (AUTHOR), Gohmann, Robin1 (AUTHOR), Hahn, Jochen5 (AUTHOR), Fischer, Julia4 (AUTHOR), Gutberlet, Matthias1 (AUTHOR), Lehmkuhl, Lukas1,3 (AUTHOR)
Source: European Radiology. Aug2020, Vol. 30 Issue 8, p4317-4326. 10p. 1 Color Photograph, 3 Charts, 2 Graphs.
Subjects: Computed tomography, Angiography, Coronary angiography, Heart transplantation
Abstract: Objectives: To associate coronary wall volume and composition, derived from coronary computed tomography angiography (CTA), with cardiac allograft vasculopathy (CAV) detected on invasive coronary angiography (ICA) in heart-transplanted (HTX) patients.Methods: We included consecutive adults who received ICA and coronary CTA for evaluation of CAV ≥ 10 months after HTX. In all coronary segments, we assessed lumen and wall volumes and segmental length, calculated volume-length ratio (VLR) (volumes indexed by segmental length; mm3/mm), wall burden (WB) (wall/wall + lumen volumes; %), and assessed proportions of calcified, fibrotic, fibro-fatty, and low-attenuation tissue (%) in coronary wall. We rendered independent CTA measures associated with CAV by ICA, tested their discriminatory capacity, and assessed concordance between CTA and ICA.Results: Among 50 patients (84% men; 53.6 ± 11.9 years), we analyzed 632 coronary segments. Mean interval between HTX and CTA was 6.7 ± 4.7 years and between ICA and CTA 1 (0-1) day. Segmental VLR, WB, and proportion of fibrotic tissue were independently associated with CAV (OR = 1.06-1.27; p ≤ 0.002), reaching a high discriminatory capacity (combination of all three: AUC = 0.84; 95%CI, 0.75-0.90). Concordance between CTA and ICA was higher in advanced CAV (88%) compared with that in none (37%) and mild (19%) CAV. Discordance was primarily driven by a large number of segments with coronary wall changes on CTA but without luminal stenoses on ICA (177/591; 25%).Conclusion: CTA-derived coronary wall VLR, WB, and the proportion of fibrotic tissue are independent markers of CAV. Combination of these three parameters may aid the detection of early CAV not detected by ICA, the current standard of care.Key Points: • Coronary CTA detects CAV in HTX patients. • Coronary wall volume-length ratio, wall burden, and proportion of fibrotic tissue are independently associated with CAV. • In contrast to ICA, coronary CTA may identify the early stages of CAV. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Quantitative coronary computed tomography angiography for the detection of cardiac allograft vasculopathy.
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  Data: <searchLink fieldCode="AR" term="%22Foldyna%2C+Borek%22">Foldyna, Borek</searchLink><relatesTo>1,2,3</relatesTo> (AUTHOR)<i> bfoldyna@mgh.harvard.edu</i><br /><searchLink fieldCode="AR" term="%22Sandri%2C+Marcus%22">Sandri, Marcus</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Luecke%2C+Christian%22">Luecke, Christian</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Garbade%2C+Jens%22">Garbade, Jens</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gohmann%2C+Robin%22">Gohmann, Robin</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hahn%2C+Jochen%22">Hahn, Jochen</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fischer%2C+Julia%22">Fischer, Julia</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gutberlet%2C+Matthias%22">Gutberlet, Matthias</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lehmkuhl%2C+Lukas%22">Lehmkuhl, Lukas</searchLink><relatesTo>1,3</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Aug2020, Vol. 30 Issue 8, p4317-4326. 10p. 1 Color Photograph, 3 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Angiography%22">Angiography</searchLink><br /><searchLink fieldCode="DE" term="%22Coronary+angiography%22">Coronary angiography</searchLink><br /><searchLink fieldCode="DE" term="%22Heart+transplantation%22">Heart transplantation</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: <bold>Objectives: </bold>To associate coronary wall volume and composition, derived from coronary computed tomography angiography (CTA), with cardiac allograft vasculopathy (CAV) detected on invasive coronary angiography (ICA) in heart-transplanted (HTX) patients.<bold>Methods: </bold>We included consecutive adults who received ICA and coronary CTA for evaluation of CAV ≥ 10 months after HTX. In all coronary segments, we assessed lumen and wall volumes and segmental length, calculated volume-length ratio (VLR) (volumes indexed by segmental length; mm3/mm), wall burden (WB) (wall/wall + lumen volumes; %), and assessed proportions of calcified, fibrotic, fibro-fatty, and low-attenuation tissue (%) in coronary wall. We rendered independent CTA measures associated with CAV by ICA, tested their discriminatory capacity, and assessed concordance between CTA and ICA.<bold>Results: </bold>Among 50 patients (84% men; 53.6 ± 11.9 years), we analyzed 632 coronary segments. Mean interval between HTX and CTA was 6.7 ± 4.7 years and between ICA and CTA 1 (0-1) day. Segmental VLR, WB, and proportion of fibrotic tissue were independently associated with CAV (OR = 1.06-1.27; p ≤ 0.002), reaching a high discriminatory capacity (combination of all three: AUC = 0.84; 95%CI, 0.75-0.90). Concordance between CTA and ICA was higher in advanced CAV (88%) compared with that in none (37%) and mild (19%) CAV. Discordance was primarily driven by a large number of segments with coronary wall changes on CTA but without luminal stenoses on ICA (177/591; 25%).<bold>Conclusion: </bold>CTA-derived coronary wall VLR, WB, and the proportion of fibrotic tissue are independent markers of CAV. Combination of these three parameters may aid the detection of early CAV not detected by ICA, the current standard of care.<bold>Key Points: </bold>• Coronary CTA detects CAV in HTX patients. • Coronary wall volume-length ratio, wall burden, and proportion of fibrotic tissue are independently associated with CAV. • In contrast to ICA, coronary CTA may identify the early stages of CAV. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-019-06653-3
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      – Code: eng
        Text: English
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        PageCount: 10
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        Type: general
      – SubjectFull: Angiography
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      – SubjectFull: Coronary angiography
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      – SubjectFull: Heart transplantation
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      – TitleFull: Quantitative coronary computed tomography angiography for the detection of cardiac allograft vasculopathy.
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              Text: Aug2020
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