PT  - JOURNAL ARTICLE
AU  - Tobias Rutz
AU  - Steffen Gloekler
AU  - Stefano F de Marchi
AU  - Tobias Traupe
AU  - Pascal Meier
AU  - Parham Eshtehardi
AU  - Stéphane Cook
AU  - Rolf Vogel
AU  - Paul Mohacsi
AU  - Christian Seiler
TI  - Coronary collateral function in the transplanted heart: propensity score matching with coronary artery disease
AID  - 10.1136/hrt.2010.215137
DP  - 2011 Apr 01
TA  - Heart
PG  - 557--563
VI  - 97
IP  - 7
4099  - http://heart.bmj.com/content/97/7/557.short
4100  - http://heart.bmj.com/content/97/7/557.full
SO  - Heart2011 Apr 01; 97
AB  - Background The function of the coronary collateral circulation in heart transplant patients has not been investigated in a controlled fashion. Since it partly belongs to the microcirculation, which is affected by transplant vasculopathy, the hypothesis was tested that the coronary collateral circulation in heart transplant recipients is less developed than in coronary artery disease (CAD) patients.Methods 40 heart transplant patients underwent a total of 51 quantitative, coronary pressure-derived collateral measurements and intravascular ultrasound (IVUS). The collateral flow index (CFI) was calculated as mean coronary occlusive pressure divided by mean aortic pressure, both subtracted by central venous pressure. A propensity score matching for angiographic coronary stenosis severity, heart rate, the presence of arterial hypertension and dyslipidaemia was performed using CAD patients of the institutional CFI database (n=1076) as the control group.Results Eighty per cent (32/40) of the heart transplant patients showed transplant vasculopathy as assessed by IVUS (intima thickness ≥0.5 mm). Without propensity score matching, CFI was equal to 0.152±0.102 in the heart transplant group (age 55±14 years) and 0.189±0.134 in the entire CAD group (p=0.054). After matching, CFI was 0.152±0.102 in the heart transplant group and 0.176±0.096 (p=0.37) in the matched CAD group (age 63±10 years). IVUS data were unrelated to CFI in the heart transplant group.Conclusions Heart transplant patients present with the same degree of functional collateral flow compared with a matched group of CAD patients.