(817) - Cardiac Allograft Vasculopathy Assessed By Quantitative Coronary Angiography: A Single Center Prospective Study

Abstract

s S297 Methods: Retrospective data from 27 heart transplant patients who underwent endomyocardial biopsy, cardiac diastolic function evaluation by echocardiography at rest and maximum physical capacity evaluation by ergospirometry were collected and analysed in a double-blind trial. Also, it was obtained myocardial biopsy of 10 control patients from a previous study. No other data was obtained from them. In order to realize the histological analysis, slides were stained by picrosirius-polarization (quantitative analysis of collagen). The picrosirius-polarization stained slides were scanned and transferred to a software to quantify the area of fibrosis. It was determined these images would be obtained from 40x magnification and from well distributed and noncoincident microscopic fields, with over 50% of tissue area and without large arterioles, pericardium or endocardium. Five to ten photos per slide were obtained, totalizing an area between 0.46mm2 and 0.92mm2. Afterwards, a statistical data analysis was performed correlating the area of fibrosis with the other data of the transplanted patients. The results were considered significant at p-value inferior to 0.05. Results: It was observed a percentage of 7,43% of fibrosis from the transplanted patients, and a percentage of 1,99% of fibrosis in the control patients. The percentage of fibrosis was considered significant in the transplanted patients (p= 0,037 in Kolmogorov-Sminov test, and p= 0,000 in Shapiro-Wilk test), and considered significant in the control group by Shapiro-Wilk test (p= 0,001). The correlation of fibrosis area and data of diastolic cardiac function (E/E’) and physical capacity (mean VO2 after six minutes, max VO2) for each transplanted patient resulted in significance values all above 0,05. Conclusion: The presence of fibrosis in the myocardial tissue in heart transplant patients was considered significant in comparison with the control group. However, it was not possible to establish a correlation of the area of fibrosis and the diastolic heart dysfunction and physical capacity in transplanted patients.