Heart failure & cardiomyopathiesCohort study
Microvascular Resistance Reserve and Prognosis After Heart Transplantation
- Prospective cohort study
Authors' conclusion
Impaired microcirculatory function, determined by MRR early after heart transplantation, identified patients at high risk for death or acute cellular rejection, regardless of epicardial coronary artery stenosis or elevated microcirculatory resistance.
Study context
- Population
- Heart transplant recipients undergoing scheduled coronary angiography and invasive coronary physiological assessment 1 month after transplantation
- Participants
- 34 vs 122
- Exposure
- Impaired vs preserved microcirculatory function
- Microvascular resistance reserve (MRR) ≤3.0n = 34
- MRR >3.0n = 122reference
- Outcome
- Death or biopsy-proven acute cellular rejection grade ≥2R
- Follow-up
- Median 730 days
Main finding
Death or acute cellular rejection
Adjusted hazard ratio
5.31
95% CI 2.65–10.64
P < 0.001
MRR ≤3.0 vs MRR >3.0
adjusted HR 5.31 (95% CI 2.65–10.64); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Acute cellular rejection | 4.83 (2.20–10.60) | P < 0.001 | |
| Death | 5.19 (1.24–21.62) | P = 0.024 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Death or acute cellular rejection per 1-U decrease in MRR (continuous)
- HR adjusted for fractional flow reserve, per 1-U decrease in MRR
- 1.89 (95% CI 1.46-2.46; P < 0.001)
- HR adjusted for index of microcirculatory resistance, per 1-U decrease in MRR
- 1.90 (95% CI 1.43-2.52; P < 0.001)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Microvascular Resistance Reserve and Prognosis After Heart Transplantation. JACC Cardiovasc Interv. Published 24 February 2025. doi:10.1016/j.jcin.2024.11.011
Summarised from the published abstract; every number is checked against it