Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Cytomegalovirus (CMV) has been documented as a risk factor for the development of cardiac allograft vasculopathy (CAV) after heart transplantation (HTx). It has not been firmly established whether CMV would cause an increase in first-year intimal thickening via intravascular ultrasound (IVUS) in the current tacrolimus era. First-year maximal intimal thickening (MIT) ≥0.5mm has been found to be predictive of poor outcome (worse survival, CAV) at 5-years post-transplant. In addition, there has not been a differentiation between CMV infection, CMV syndrome, and CMV disease as it applies to IVUS intimal thickening. CMV infection is noted by positive IgG CMV serology only; CMV syndrome refers to patients with documented CMV virus along with a clinical presentation; CMV disease is defined as organ-specific CMV infection i.e. CMV pneumonitis, CMV colitis etc. Therefore, we sought to use first-year IVUS to determine whether CMV infection, syndrome, or disease would lead to more first-year MIT ≥0.5mm.
*Methods: Between 2010 and 2017, 294 heart transplant patients underwent baseline and 1-year IVUS. These patients were then divided into 4 groups: (Group A – no CMV infection (n=108); Group B – CMV infection (n=173); Group C – CMV syndrome (n=9); and Group D – CMV disease (n=3)). Diagnosis of CAV was based on a ≥ 0.5 mm increase in maximal intimal thickness (MIT) from baseline.
*Results: Baseline MIT was similar among all study groups. The percent of patients with first-year MIT ≥0.5mm was also similar among all patient groups.
*Conclusions: The development of CMV infection, syndrome and disease, does not appear to increase CAV risk by first-year MIT obtained by IVUS in the current tacrolimus era. Larger number of patients with longer follow-up studies are warranted to confirm these findings.
|Endpoints||Group A (n=108)||Group B (n=173)||Group C (n=9)||Group D (n=3)||P-Value|
|Mean Baseline MIT (mm) ± SD||0.4 ± 0.4||0.4 ± 0.4||0.4 ± 0.4||0.3 ± 0.4||0.292|
|Mean 1-Year MIT (mm) ± SD||0.7 ± 0.6||0.6 ± 0.5||0.6 ± 0.6||0.5 ± 0.5||0.395|
|Δ MIT ≥ 0.5 mm, %||19.4%||24.4%||22.2%||33.3%||0.399|
To cite this abstract in AMA style:Dimbil S, Kittleson M, Patel J, Geft D, Cheng R, Levine R, Sato T, Czer L, Zabner R, Zakowski P, Kobashigawa JA, Azarbal B. The Use Of First-year Intravascular Ultrasound In The Tacrolimus Era In Heart Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-use-of-first-year-intravascular-ultrasound-in-the-tacrolimus-era-in-heart-transplantation/. Accessed December 4, 2020.
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