PERIPHERAL VASCULAR DISEASE IN CARDIAC TRANSPLANTATION: ABNORMAL CAROTID WALL THICKNESS

Abstract

399 Background Abnormal carotid intima-media thickness is an early indicator of peripheral disease and may precede the development of atherosclerosis in other vascular beds. Heart transplant recipients demonstrate progression of symptomatic peripheral vascular disease. Objectives To assess in heart transplant recipients: 1) the prevalence and risk factors associated with the development of carotid intima media thickness (IMT) 2) the yearly progression of carotid intima media thickness. Methods 14 cardiac transplant recipients (CTX) were matched by age, sex, lipid profile with 14 patients awaiting heart transplantation (PRETX) and 14 normal patients (NC). All patients underwent B mode carotid ultrasound and IMT was measured in 3 segments of common, internal and bifurcation (B) of right and left carotid arteries. Arteries were measured longitudinally with intima - media thickness measured from the far wall of the arteries. Distance between the echoes arising from the blood - intima interface and the media - adventitia interface were taken as the IM thickness. IMT was performed at baseline and one year post heart transplantation in eight of fourteen(CTX) Results (mean±SD) (Table)TableTransplant recipients who had baseline and yearly post transplant studies did not demonstrate any progression in carotid intima-media thickness [(B)1.18 ± 0.35 and (1 year) 1.25 ± 0.20] Conclusions Abnormal IMT (0.85mm) was more commonly noticed in the carotid bifurcation. Age and ischemic cardiomyopathy were independent predictors of a higher degree of IMT (p<0.01). All patients with ischemic etiology have a higher degree of IMT. Regardless of etiology 44% of patients following cardiac transplantation had abnormal IMT, however there was no progression of IMT one-year post transplantation. Future prospective studies are underway to delineate the clinical repercussion of carotid IMT in cardiac transplantation.