Academic Radiology
Volume 16, Issue 2 , Pages 194-199, February 2009

Progression of Coronary Atherosclerosis After Heart Transplantation on Electron-beam Computed Tomography

  • Friedrich D. Knollmann, MD, PhD

      Affiliations

    • Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite E-177 PUH, Pittsburgh, PA 15213-2582
    • Corresponding Author InformationAddress correspondence to: F.D.K.
    • ,
  • Franziska Stühmer

      Affiliations

    • Department of Radiology, Charité, Virchow Hospital Campus, Humboldt University of Berlin, Berlin, Germany
    • ,
  • Hans Lehmkuhl, MD

      Affiliations

    • Department of Cardiothoracic and Vascular Surgery, German Heart Institute, Berlin, Germany
    • ,
  • Roland Felix, MD, PhD

      Affiliations

    • Department of Radiology, Charité, Virchow Hospital Campus, Humboldt University of Berlin, Berlin, Germany
    • ,
  • Roland Hetzer, MD, PhD

      Affiliations

    • Department of Cardiothoracic and Vascular Surgery, German Heart Institute, Berlin, Germany

Received 6 June 2008; accepted 8 July 2008.

Rationale and Objectives

Cardiac transplant vasculopathy is the most important long-term complication of heart transplantation, with overlapping features with conventional, atherosclerotic coronary artery disease. The aim of this study was to determine the progression of coronary artery disease after heart transplantation by measuring total coronary calcium load.

Materials and Methods

After heart transplantation, 185 patients were serially examined using electron-beam computed tomography for coronary calcium load for clinical reasons. The mean time between the initial examination and the follow-up scan was 566 days (range, 126–1,436). Coronary calcium load was measured by the Agatston method, and the total calcium scores at both examinations were compared between patients taking and those not taking lipid-lowering medications (statins).

Results

Patients not taking statins (n = 94) displayed a median annualized percentage increase in total calcium score of 0 Agatston units, whereas patients taking at least the lowest recommended daily dose of a statin (n = 84) displayed an annualized percentage decrease of 11 Agatston units. The difference was not statistically significant (Wilcoxon's rank-sum test, P = .35). Only 17 patients had increases of > 24 Agatston units, and eight of them were taking statins (χ2 test, P = .99).

Conclusion

The annual rate of progression of coronary calcium load after heart transplantation is low. In this investigation, no beneficial effects of statins could be detected.

Key Words: Heart transplantation, coronary disease, computed tomography

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PII: S1076-6332(08)00417-0

doi:10.1016/j.acra.2008.07.014

Academic Radiology
Volume 16, Issue 2 , Pages 194-199, February 2009

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