Heart failure & cardiomyopathies
Prognostic value of comprehensive intracoronary physiology assessment early after heart transplantation
Authors' conclusion
Abnormal coronary physiology 1 year after heart transplantation was common and was a significant predictor of death or re-transplantation at 10 years.
Study context
- Population
- Heart transplant recipients undergoing intracoronary physiology assessment (fractional flow reserve (FFR), index of microcirculatory resistance (IMR), coronary flow reserve (CFR)) at baseline (median 7.2 weeks) and/or 1 year after transplantation254 at baseline, 240 at 1 year
- Exposure
- Reduced FFR or microvascular dysfunction vs normal coronary physiology after heart transplantation
- Outcome
- Death or re-transplantation
- Follow-up
- 10 years
Methodological detailsmulticentre registry, 199 patients had both baseline and 1-year measurement
- Multicentre registry
- 199 patients had both baseline and 1-year measurement
Main finding
As reported in the abstract
Death or re-transplantation, by 1-year physiology
Each group vs normal physiologyAdjusted hazard ratio (95% CI)P value
Reduced FFR
2.98(1.13–7.87)
P = 0.028Microvascular dysfunction
2.33(1.19–4.59)
P = 0.015Observational data: associations, not effects.
Further findings
| Outcome | Normal physiology | Reduced FFR | Microvascular dysfunction | aHR (95% CI) | P value | |
|---|---|---|---|---|---|---|
| Death or re-transplantation, by baseline physiology · 10 yearsReduced FFR vs Normal physiology · baseline assessment · per_group values are prevalence at baseline | Not reported in the abstract | 5.5% | 36.6% | 2.33 (0.88–6.15) | P = 0.088 | Normal physiology: not reported in the abstract |
| Death or re-transplantation, by baseline physiology · 10 yearsMicrovascular dysfunction vs Normal physiology · baseline assessment · per_group values are prevalence at baseline | 0.88 (0.44–1.79) | P = 0.73 | ||||
| 0.10.31310Adjusted hazard ratio (log scale) |
Incremental prognostic value of invasive physiology over clinical variables
- χ2 improvement
- 7.41, P = 0.006
IVUS-derived change in maximal intimal thickness
- Not predictive of outcomes
Original publication
Prognostic value of comprehensive intracoronary physiology assessment early after heart transplantation. Eur Heart J. Published 19 October 2021. doi:10.
Summarised from the published abstract; every number is checked against it