Coronary angiography for follow-up of heart transplant recipients: Insights from TIMI frame count and TIMI myocardial perfusion grade
Coronary angiography for follow-up of heart transplant recipients: Insights from TIMI frame count and TIMI myocardial perfusion grade
复制标题
DOI：
10.1016/j.healun.2007.03.016
复制
发表时间：
2007-06-01
影响因子：
8.9
通讯作者：
Tuzcu, E. Murat
中科院分区：
文献类型：
--
作者：
Baris, Nezihi;Sipahi, Ilke;Tuzcu, E. Murat
背景资料：本研究的目的是评估心脏移植受者的心肌梗死溶栓（TIMI）过程中，帧计数（TIMI FC）和心肌灌注分级（TIMI MPG），以及这些参数是否可以预测死亡率。所有患者在基线和第1年时均行冠状动脉造影，评价TIMI FC和TIMI MPG。此外，在基线和第1年时，对35例患者的50条血管进行了容积血管内超声（IVUS）分析。随访期间记录排斥反应事件和死亡率。结果：平均随访间隔为51.5 +/- 17.2个月（范围12.2至78.4个月）。在第一年，所有三支冠状动脉的TIMI FC和总体TIMI FC（gTIMI FC）均较基线显著增加（p < 0.0001）。TIMI MPG显著恶化（左前降支和回旋支冠状动脉p < 0.0001，右冠状动脉p = 0.002）。通过IVUS评估，TIMI FC变化与移植血管病变进展之间无相关性。在稳定gTIMI FC组中，≥ 3A级排斥反应的发生率显著更高（p = 0.03）。结论：冠状动脉移植术后1年内，冠状动脉gTIMIFCs和TIMIFCs增加，TIMIMPG逐渐恶化。gTIMI FC较基线升高的患者的死亡率显著较高。gTIMI FC的变化是心脏移植受者长期死亡率的简单定量预测因子。
Background: The aim of this study was to evaluate the course of Thrombolysis in Myocardial Infarction (TIMI) frame count (TIMI FC) and myocardial perfusion grade (TIMI MPG) in heart transplant recipients and whether these parameters could predict mortality.Methods: Sixty-two heart transplant recipients were enrolled in this study. All patients had coronary angiography at baseline and at I year, which were evaluated for TIMI FC and TIMI MPG. Also, 50 vessels in 35 patients were analyzed with volumetric intravascular ultrasound (IVUS) at baseline and at I year. Rejection episodes and mortality were recorded during the follow-up period.Results: The mean follow-up interval was 51.5 +/- 17.2 months (range 12.2 to 78.4 months). TIMI FCs of all three coronary arteries and global TIMI FC (gTIMI FC) significantly increased from baseline during the first year (p < 0.0001). TIMI MPG deteriorated significantly (p < 0.0001 for left anterior descending and circumflex coronary arteries, p = 0.002 for right coronary artery). There was no correlation between changes in TIMI FC and progression of transplant vasculopathy as assessed by IVUS. Episodes of Grade >= 3A rejection were significantly more frequent in the stable gTIMI FC group (p = 0.03). Mortality rate was significantly higher in the group with increasing gTFC (p = 0.02).Conclusions: gTIMI FCs and TIMI FCs of coronary arteries increase, and TIMI MPG gradually deteriorates during the first year after transplantation. Mortality rate is significantly higher in patients whose gTIMI FC increases from baseline. Change in gTIMI FC is a simple quantitative predictor of long-term mortality in heart transplant recipients.