Abstract
This study tests the correlation of coronary angiographic findings with the extent
of microvascular reaction in right ventricular endomyocardial biopsies (EMBs) in transplanted
hearts. In EMBs (n = 209) of 30 heart transplant patients (8 female, 22 male, mean
age 48 years) microvascular reaction, i.e. endothelial cell swelling and vascular
wall thickening (both grade 0-2), was graded by light microscopy at ×200. Patients'
first and last coronary angiography (CA) (mean time after heart transplantation [HTx]
8 and 44 months) were graded according to the Stanford Classification and the presence
of diameter irregularities was evaluated semi-quantitatively. We found a correlation
of angiographic type B lesions with endothelial cell swelling during the first 5 months
and vascular wall thickening during the fifth to fourteenth month after HTx (p <0.05).
In patients with diameter irregularities and type B1 lesions in their first CA and
type C lesions in their last CA, there was pronounced endothelial cell swelling in
the early postoperative period (p <0.05). There was a tendency towards an increased
vascular wall thickening in these patients during the later postoperative period.
Graft vessel disease affects large and small coronary arteries and capillaries. Small
vessel disease is characterized by architectural changes in blood vessel walls. Serial
investigations of EMBs for diagnosis of small vessel disease complement the present
diagnostic tools.
