Heart transplantation is an effective life-saving treatment for patients with end-stage heart disease. After a transplant, the new heart may develop narrowing in the arteries, causing heart failure, heart attacks and abnormal heart rhythms. This condition is known as cardiac allograft vasculopathy (CAV). The disease is very common, affecting almost a third of heart transplant patients by 5 years after transplant. CAV is a serious problem that causes the new heart to fail and is one of the main causes of death after transplant. Early detection of CAV is important as treatment options are poor once the disease is established. Currently, available techniques to evaluate CAV are limited by poor ability to detect disease early. The current tests usually focus on the large heart arteries and do not examine the smaller arteries that are also affected.
The objective of this study is to determine whether early abnormalities of the heart arteries after heart transplantation can predict the development of CAV. We will use a combination of sophisticated imaging tools to examine in detail the early changes that occur in the arteries of a new heart. Heart transplant patients from the University of Ottawa Heart Institute and Toronto General Hospital will undergo a series of tests at 3 and 12 months after transplant. Statistical analyses will determine whether results from the above tests at 3 months predict the development of early CAV at 12 months after a heart transplant.
Study Type
OBSERVATIONAL
Enrollment
80
University of Ottawa Heart Institute
Ottawa, Ontario, Canada
CAV on invasive coronary studies
Changes in coronary intima on IVUS and OCT and invasive coronary flow
Time frame: 3 months and 1-year post-transplant.
EMBx
Microvascular disease
Time frame: 3 months post-transplant
PET
Myocardial blood flow quantification
Time frame: 3 months post-transplant
Biomarkers
Serum biomarker panel
Time frame: 3 months post-transplant
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