Influence of coronary flow velocity reserve based on echocardiogram detection on long-term prognosis in heart transplant recipients
CHEN Heng
YU Huijuan
YANG Fan
CHEN Jianchao
Abstract：Objective Cardiac allograft vasculopathy(CAV)following heart transplantation(HTx)is a major factor affecting patients'long-term prognosis.Invasive coronary angiography(CAG)is the gold standard for CAV monitoring,but it carries certain risks and may underestimate early-stage lesions.This study aimed to investigate the predictive value of coronary flow velocity reserve(CFVR)measured by echocardiography for the long-term prognosis in HTx patients.Methods This study is a single center retrospective study that included 90 patients who received HTx in the Seventh People's Hospital of Zhengzhou City from Jan.2020 to Apr.2024.CFVR,defined as the ratio of blood flow velocity under adenosine-induced hyperemia to that at rest,was evaluated by echocardiography to explore its association with the primary endpoint events,including all-cause mortality and major adverse cardiac events(MACE).Kaplan-Meier survival analysis and Cox proportional hazards model were applied for assessment.Results The percentage of CAV was 94.4%in low-CFVR group(CFVR<2),which was significantly higher than that in high-CFVR group(26.4%,χ2=29.7,P<0.001).CAV grading analysis showed that grade 3 CAV was predominant in low-CFVR group(44.4%),whereas grade 0 CAV was predominant in high-CFVR group(73.6%,χ2=31.8,P<0.001).The usage rate of aspirin was 72.2%in low-CFVR group,which was significantly higher than that in high-CFVR group(34.7%,χ2=8.7,P=0.003).The parameters of biventricular systolic function were significantly impaired in low-CFVR group.Diastolic function analysis showed that low-CFVR group exhibited a more pronounced restrictive filling pattern.The median MACE free survival rate was 23.5 months in low-CFVR group,which was significantly lower than that in high-CFVR group(46 months;HR=2.785,95%CI:1.322～5.867,P=0.007).The median survival rate was 30.5 months in low-CFVR group,which was significantly lower than that in high-CFVR group(49 months;HR=4.808,95%CI:2.112～10.98,P=0.0002).Conclusion CFVR is a predictive indicator for long-term prognosis in HTx patients,and its non-invasive nature supports its application as a routine CAV monitoring tool.
Keywords：heart transplantationcardiac allograft vasculopathycoronary flow velocity reserveechocardiogramlong-term prognosis
Publication Date：2025-12-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：5( 1470-1474 )