IMAGES IN CARDIOLOGY Download full-text
Cardiac Allograft Vasculopathy Progression
Associated With Intraplaque Neovascularization
Yasuhiro Ichibori, MD,* Daisaku Nakatani, MD, PHD,* Yasushi Sakata, MD, PHD,*
Kouichi Tachibana, MD, PHD,* Takashi Akasaka, MD, PHD,† Shunsuke Saito, MD, PHD,‡
Norihide Fukushima, MD, PHD,‡ Yoshiki Sawa, MD, PHD,‡ Shinsuke Nanto, MD, PHD,*
Issei Komuro, MD, PHD*
Osaka and Wakayama, Japan
From the *Department of
Osaka University Graduate
School of Medicine, Osaka,
Japan; †Department of
University, Wakayama, Japan;
and the ‡Department of
Cardiovascular Surgery, Osaka
University Graduate School of
Medicine, Osaka, Japan.
Dr. Akasaka has received re-
search support from Abbott
Vascular Japan, Boston Scien-
tific Japan, Goodman Inc.,
and St. Jude Medical Japan,
and Terumo Inc. and consult-
ing fees from Goodman Inc.,
St. Jude Medical Japan, and
Terumo Inc. All other authors
have reported that they have
no relationships relevant to
the contents of this paper to
August 17, 2012;
accepted August 26, 2012.
ing coronary artery (LAD) at 3 months (B, Online Video 1). However, at 12 months, CAV
progression was detected, predominantly in the proximal LAD (A and C3, Online Video 2).
Corresponding optical coherence tomography images revealed the presence of many no-signal
tubuloluminal structures within the fibrous plaque in serial frames. Parts of those structures
were found to be connected to the vessel lumen, indicating neovascularization (D2, D3, D4,
and E [arrows], Online Video 3). No neovascularization was observed in lesions without CAV
progression (C1 and D1). To our best knowledge, this is the first reported case demonstrating
CAV progression associated with intraplaque neovascularization in vivo. Intraplaque neovascu-
larization could play an important role in CAV progression. DB ? diagonal branch; LCX ?
left circumflex coronary artery.
52-year-old man underwent scheduled cardiac catheterization for assessment of car-
diac allograft vasculopathy (CAV) at 3 and 12 months after heart transplantation
(HTx). Intravascular ultrasound showed only mild CAV in the left anterior descend-
Journal of the American College of Cardiology
© 2013 by the American College of Cardiology Foundation
Published by Elsevier Inc.
Vol. 61, No. 9, 2013