Abstract 15856: Peripheral Arterial Tonometry Has Low Sensibility for Cardiac Allograft Vasculopathy Detection

Abstract

Introduction: Cardiac allograft vasculopathy (CAV) is the main cause of chronic graft failure in cardiac transplant patients and plays a significant role in overall morbimortality of the post-transplantation population. In spite of the many available exams currently able to detect CAV subclinical development, they generally display important clinical limitations and lack early diagnosis sensibility. Therefore, the investigation of alternative technologies is essential for the better recognition and prevention of such condition. Methods: Exploratory study on the use of peripheral arterial tonometry as assessment of endothelial health of post-transplant patients. Patients were enrolled from Brazil’s 3rd largest heart transplant center, Instituto de Medicina Integral Professor Fernando Figueira, and subsequently evaluated with EndoPAT2000 between August 2019 and February 2020, when COVID-19 pandemic prematurely concluded the study. Eligible patients had at least 2 years of transplant afterlife and were regularly hospital monitored. The patients’ cardiac catheterism records were collected for more accurate comparison with endothelial results. Medications, preexisting conditions, and transplant information were acquired from medical records. The main outcomes consisted of peripheral arterial tonometry detection capability of endothelial abnormality degree and CAV. Results: Sample size of 22 patients (mean age 50.9, 90.9% men) submitted for EndoPAT2000 exam. Of these, 14 had prior catheterism records (3 had confirmed CAV, 2 coronary fistulas, 9 no abnormalities) and 9 didn′t. When compared with the non catheterism group (2.25 ± 0.41, 0.80 ± 0.19, 8.13 ± 12.21, 16.49 ± 13.87) patients who underwent the procedure (1.89 ± 0.56, 0.60 ± 0.28, 0.72 ± 10.78, 8.54 ± 12.69) had reasonably lower RHI, LnRHI, AI, and AI@75 respectively. CAV confirmed patients (1.99 ± 0.69, 0.65 ± 0.34, -2.07 ± 3.72, 4.40 ± 6.74) had no significant RHI differences, yet displayed slightly lower AI values. Conclusion: The findings of this study suggest there was no significant difference of endothelial health per peripheral arterial tonometry examination between the average catheterism population and CAV patients. Larger studies are needed to confirm such findings.