Myocardial vacuolization, a marker of XXXX , in surveillance cardiac biopsies posttransplant: Correlations with morphologic vascular disease and @entity409 .

@entity1 @entity63 @entity409 @entity3885 @entity934
Allograft vasculopathy (AV) causes intimal thickening with progressive @entity3885 , @entity409 , and abnormal vasomotion. Subendocardial vacuolization indicating ongoing @entity63 was observed at autopsy in transplanted hearts with severe AV. Whether myocyte vacuolization can be observed with lesser degrees of AV in cardia transplant @entity1 has not been reported. Thirty-nine cardiac transplant @entity1 without flow-limiting disease in large epicardial arteries underwent invasive assessment of AV. Eight to 10 segments of the left anterior descending artery were analyzed by intracoronary ultrasound, and an average intimal index was calculated. Endothelial response to @entity934 was assessed with serial quantitative angiography. Endomyocardial biopsies taken 5 to 7 days prior to the invasive studies were histopathologically reviewed for the presence of small intramyocardial arteries and myocyte vacuolization. Myocyte vacuolization was evident in biopsies from 20 @entity1 (51%). Intramyocardial arteries were observed in 30 cases (76%); 14 had abnormal arteries. All @entity1 had some degree of intimal thickening by intracoronary ultrasound, and 7 (17 %) had severely abnormal average intimal index (>0.2). @entity409 was present in 23 @entity1 (58%). Vacuolization failed to show an association with abnormal small artery histology or large epicardial artery ultrasound disease. However, a significant association between vacuolization and @entity409 was observed (p = 0.05). Myocyte vacuolization, possibly indicating @entity63 , is common in biopsies from cardiac transplant @entity1 and is associated with abnormal @entity934 response in large epicardial arteries. We speculate that myocyte vacuolization may be caused at least in part by impaired coronary flow associated with @entity409 .
