Quantitative CT assessment identifies more heart transplanted patients with progressive coronary wall thickening than standard clinical read

Mihály Károlyi, Márton Kolossváry, Andrea Bartykowszki, Ildikó Kocsmár, Bálint Szilveszter, Júlia Karády, B. Merkely, Pál Maurovich-Horvat

Research output: Contribution to journalArticle

Abstract

Background: We sought to compare quantitative coronary CT angiography (CTA) assessment versus standard clinical reading to identify heart transplanted (HTX) patients with progressive coronary wall thickening. Methods: 35 patients (23 males, age 58 [IQR: 50;61] years) underwent 256-slice coronary CTA at one year and two years after HTX to rule out cardiac allograft vasculopathy (CAV). In addition to the standard clinical read, we quantified total vessel wall volume in all coronaries up to 2-mm luminal diameter. Fixed threshold settings were used to assess calcified (>350 HU) and non-calcified vessel wall components with high- (131–350 HU), intermediate- (75–130 HU) and low-attenuation (<75 HU). Results: Total lumen volume did not change between baseline and follow-up studies (p = 0.59). Total vessel wall volume showed significant increase (464 [IQR: 338; 570] vs. 563 [IQR: 345; 717] mm3, p < 0.001). The volume of high-, intermediate and low-attenuation non-calcified wall components showed progression (332 [IQR: 217;425] vs. 385 [IQR: 238;489], 40 [IQR: 12;48] vs. 59 [IQR: 16;83] and 18 [IQR: 4;21] vs. 46 [IQR: 6;41] mm3, respectively, p < 0.05 all), while calcified volume did not change between baseline and follow-up CTAs (72 [IQR: 16;127] vs. 72 [IQR: 29;102] mm3, p = 0.73). Quantitative analysis identified more patients with progressive coronary wall thickening (≥10% cut-off) than standard clinical read (11 vs. 22, p = 0.01). Conclusion: Quantitative coronary wall assessment is feasible with coronary CTA in HTX patients. Coronary wall thickening within the first two years after HTX is mainly attributable to non-calcified lesion components and might be an early sign of CAV.

Original languageEnglish
JournalJournal of Cardiovascular Computed Tomography
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Coronary Angiography
Allografts
Reading
Computed Tomography Angiography

Keywords

  • Cardiac allograft vasculopathy
  • Coronary artery disease
  • Coronary CT angiography
  • Coronary vessels
  • Heart transplantation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Quantitative CT assessment identifies more heart transplanted patients with progressive coronary wall thickening than standard clinical read. / Károlyi, Mihály; Kolossváry, Márton; Bartykowszki, Andrea; Kocsmár, Ildikó; Szilveszter, Bálint; Karády, Júlia; Merkely, B.; Maurovich-Horvat, Pál.

In: Journal of Cardiovascular Computed Tomography, 01.01.2018.

Research output: Contribution to journalArticle

Károlyi, Mihály ; Kolossváry, Márton ; Bartykowszki, Andrea ; Kocsmár, Ildikó ; Szilveszter, Bálint ; Karády, Júlia ; Merkely, B. ; Maurovich-Horvat, Pál. / Quantitative CT assessment identifies more heart transplanted patients with progressive coronary wall thickening than standard clinical read. In: Journal of Cardiovascular Computed Tomography. 2018.
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abstract = "Background: We sought to compare quantitative coronary CT angiography (CTA) assessment versus standard clinical reading to identify heart transplanted (HTX) patients with progressive coronary wall thickening. Methods: 35 patients (23 males, age 58 [IQR: 50;61] years) underwent 256-slice coronary CTA at one year and two years after HTX to rule out cardiac allograft vasculopathy (CAV). In addition to the standard clinical read, we quantified total vessel wall volume in all coronaries up to 2-mm luminal diameter. Fixed threshold settings were used to assess calcified (>350 HU) and non-calcified vessel wall components with high- (131–350 HU), intermediate- (75–130 HU) and low-attenuation (<75 HU). Results: Total lumen volume did not change between baseline and follow-up studies (p = 0.59). Total vessel wall volume showed significant increase (464 [IQR: 338; 570] vs. 563 [IQR: 345; 717] mm3, p < 0.001). The volume of high-, intermediate and low-attenuation non-calcified wall components showed progression (332 [IQR: 217;425] vs. 385 [IQR: 238;489], 40 [IQR: 12;48] vs. 59 [IQR: 16;83] and 18 [IQR: 4;21] vs. 46 [IQR: 6;41] mm3, respectively, p < 0.05 all), while calcified volume did not change between baseline and follow-up CTAs (72 [IQR: 16;127] vs. 72 [IQR: 29;102] mm3, p = 0.73). Quantitative analysis identified more patients with progressive coronary wall thickening (≥10{\%} cut-off) than standard clinical read (11 vs. 22, p = 0.01). Conclusion: Quantitative coronary wall assessment is feasible with coronary CTA in HTX patients. Coronary wall thickening within the first two years after HTX is mainly attributable to non-calcified lesion components and might be an early sign of CAV.",
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AU - Károlyi, Mihály

AU - Kolossváry, Márton

AU - Bartykowszki, Andrea

AU - Kocsmár, Ildikó

AU - Szilveszter, Bálint

AU - Karády, Júlia

AU - Merkely, B.

AU - Maurovich-Horvat, Pál

PY - 2018/1/1

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N2 - Background: We sought to compare quantitative coronary CT angiography (CTA) assessment versus standard clinical reading to identify heart transplanted (HTX) patients with progressive coronary wall thickening. Methods: 35 patients (23 males, age 58 [IQR: 50;61] years) underwent 256-slice coronary CTA at one year and two years after HTX to rule out cardiac allograft vasculopathy (CAV). In addition to the standard clinical read, we quantified total vessel wall volume in all coronaries up to 2-mm luminal diameter. Fixed threshold settings were used to assess calcified (>350 HU) and non-calcified vessel wall components with high- (131–350 HU), intermediate- (75–130 HU) and low-attenuation (<75 HU). Results: Total lumen volume did not change between baseline and follow-up studies (p = 0.59). Total vessel wall volume showed significant increase (464 [IQR: 338; 570] vs. 563 [IQR: 345; 717] mm3, p < 0.001). The volume of high-, intermediate and low-attenuation non-calcified wall components showed progression (332 [IQR: 217;425] vs. 385 [IQR: 238;489], 40 [IQR: 12;48] vs. 59 [IQR: 16;83] and 18 [IQR: 4;21] vs. 46 [IQR: 6;41] mm3, respectively, p < 0.05 all), while calcified volume did not change between baseline and follow-up CTAs (72 [IQR: 16;127] vs. 72 [IQR: 29;102] mm3, p = 0.73). Quantitative analysis identified more patients with progressive coronary wall thickening (≥10% cut-off) than standard clinical read (11 vs. 22, p = 0.01). Conclusion: Quantitative coronary wall assessment is feasible with coronary CTA in HTX patients. Coronary wall thickening within the first two years after HTX is mainly attributable to non-calcified lesion components and might be an early sign of CAV.

AB - Background: We sought to compare quantitative coronary CT angiography (CTA) assessment versus standard clinical reading to identify heart transplanted (HTX) patients with progressive coronary wall thickening. Methods: 35 patients (23 males, age 58 [IQR: 50;61] years) underwent 256-slice coronary CTA at one year and two years after HTX to rule out cardiac allograft vasculopathy (CAV). In addition to the standard clinical read, we quantified total vessel wall volume in all coronaries up to 2-mm luminal diameter. Fixed threshold settings were used to assess calcified (>350 HU) and non-calcified vessel wall components with high- (131–350 HU), intermediate- (75–130 HU) and low-attenuation (<75 HU). Results: Total lumen volume did not change between baseline and follow-up studies (p = 0.59). Total vessel wall volume showed significant increase (464 [IQR: 338; 570] vs. 563 [IQR: 345; 717] mm3, p < 0.001). The volume of high-, intermediate and low-attenuation non-calcified wall components showed progression (332 [IQR: 217;425] vs. 385 [IQR: 238;489], 40 [IQR: 12;48] vs. 59 [IQR: 16;83] and 18 [IQR: 4;21] vs. 46 [IQR: 6;41] mm3, respectively, p < 0.05 all), while calcified volume did not change between baseline and follow-up CTAs (72 [IQR: 16;127] vs. 72 [IQR: 29;102] mm3, p = 0.73). Quantitative analysis identified more patients with progressive coronary wall thickening (≥10% cut-off) than standard clinical read (11 vs. 22, p = 0.01). Conclusion: Quantitative coronary wall assessment is feasible with coronary CTA in HTX patients. Coronary wall thickening within the first two years after HTX is mainly attributable to non-calcified lesion components and might be an early sign of CAV.

KW - Cardiac allograft vasculopathy

KW - Coronary artery disease

KW - Coronary CT angiography

KW - Coronary vessels

KW - Heart transplantation

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