{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T09:15:59Z","timestamp":1775207759573,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T00:00:00Z","timestamp":1594684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Interventional Cardiology"],"published-print":{"date-parts":[[2020,7,14]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Cardiac allograft vasculopathy (CAV) remains the Achilles\u2019 heel of long-term survival after heart transplantation (HTx). The severity and extent of CAV is graded with conventional coronary angiography (COR) which has several limitations. Recently, vessel fractional flow reserve (vFFR) derived from COR has emerged as a diagnostic computational tool to quantify the functional severity of coronary artery disease. <jats:italic>Purpose<\/jats:italic>. The present study assessed the usefulness of vFFR to detect CAV in HTx recipients. <jats:italic>Methods<\/jats:italic>. In HTx patients referred for annual check-up, undergoing surveillance COR, the extent of CAV was graded according to the criteria proposed by the international society of heart and lung transplantation (ISHLT). In addition, three-dimensional coronary geometries were constructed from COR to calculate pressure losses using vFFR. <jats:italic>Results<\/jats:italic>. In 65 HTx patients with a mean age of 53.7\u2009\u00b1\u200910.1 years, 8.5 years (IQR 1.90, 15.2) years after HTx, a total number of 173 vessels (59 LAD, 61 LCX, and 53 RCA) were analyzed. The mean vFFR was 0.84\u2009\u00b1\u20090.15 and median was 0.88 (IQR 0.79, 0.94). A vFFR\u2009\u2264\u20090.80 was present in 24 patients (48 vessels). HTx patients with a history of ischemic cardiomyopathy (ICMP) had numerically lower vFFR as compared to those with non-ICMP (0.70\u2009\u00b1\u20090.22 vs. 0.79\u2009\u00b1\u20090.13, <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.06<\/mml:mn><\/mml:math>). The use of vFFR reclassified 31.9% of patients compared to the anatomical ISHLT criteria. Despite a CAV score of 0, a pathological vFFR\u2009\u2264\u20090.80 was detected in 8 patients (34.8%). <jats:italic>Conclusion<\/jats:italic>. The impairment in epicardial conductance assessed by vFFR in a subgroup of patients without CAV according to standard ISHLT criteria suggests the presence of a diffuse vasculopathy undetectable by conventional angiography. Therefore, we speculate that vFFR may be useful in risk stratification after HTx.<\/jats:p>","DOI":"10.1155\/2020\/9835151","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T23:32:54Z","timestamp":1594769574000},"page":"1-7","source":"Crossref","is-referenced-by-count":8,"title":["Vessel Fractional Flow Reserve and Graft Vasculopathy in Heart Transplant Recipients"],"prefix":"10.1155","volume":"2020","author":[{"given":"Sakura","family":"Nagumo","sequence":"first","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"},{"name":"Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, 2278501 Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Gallinoro","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"},{"name":"Department of Translational Medical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Candreva","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Mizukami","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"},{"name":"Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, 2278501 Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Monizzi","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Kodeboina","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"},{"name":"Department of Advanced Biomedical Sciences, Federico II University, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofie","family":"Verstreken","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riet","family":"Dierckx","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ward","family":"Heggermont","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"},{"name":"Cardiovascular Research Center Maastricht, Maastricht, AZ-6202, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozef","family":"Bartunek","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV Clinic, 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