Comparison of Optical Coherence Tomography (OCT) and Intravascular Ultrasound (IVUS) for the Early Diagnosis of Cardiac Allograft Vasculopathy in Heart Transplant Patients

Abstract

Purpose Cardiac Allograft Vasculopathy (CAV) is one of the leading causes of death after cardiac transplantation. IntraVascular Ultrasound (IVUS) measures the increase in intima-media thickness (IMT) observed in CAV and is more sensitive for diagnosis of CAV than coronary angiography. Optical Coherence Tomography (OCT), a new intracoronary imaging technique, allows more precise measurement of IMT as compared to IVUS. Objective Demonstrate that OCT is better than IVUS for CAV detection in heart transplant patients. Methods and Materials Comparison of OCT and IVUS in heart transplant patients with or without angiographic CAV, performed during their systematic follow-up coronary angiography. Results Among ten heart transplant patients included with a median age of 53.5+/−12 years, 4 had angiographically significant CAV. No major adverse cardiac events occurred during the procedure. Twenty-two coronary arteries, divided into 105 segments, were analysed. IMT measured by IVUS and OCT was comparable (limits of agreement [−0.167 – 0.139]). The 4 patients with angiographic CAV had a thicker IMT than healthy patients as defined by IVUS (0.42 ± 0.16 mm et 0.24 ± 0.10 mm respectively, p Conclusions OCT and IVUS are both reliable to measure IMT. However, only OCT can evaluate intimal thickening, the key feature of beginning CAV. OCT is therefore a promising tool in the early detection of CAV and may guide adjustment of immunosuppressive treatment aimed at reducing CAV progression.