Ghadri, Jelena R.

Lüscher, Thomas F.

Noll, Georg

Ruschitzka, Frank

Templin, Christian

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21. Moss AJ, Greenberg H, Case RB, Zareba W, Hall WJ, Brown MW, Daubret JP,McNitt S, Andrews ML, Elkin AD. Long-term clinical course of patients after ter-mination of ventricular tachyarrhythmia by an implanted defibrillator. Circulation2004;110:3760–3765.22. Poole JE, Johnson GW, Hellkamp AS, Anderson J, Callans DJ, Raitt MH, Reddy RK,Marchlinski FE, Yee R, Guarnieri T, Talajic M, Wilber DJ, Fishbein DP, Packer DL,Mark DB, Lee KL, Bardy GH. Prognostic importance of defibrillator shocks inpatients with heart failure. N Engl J Med 2008;359:1009–1017.CARDIOVASCULAR FLASHLIGHT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .doi:10.1093/eurheartj/ehs303Online publish-ahead-of-print 10 September 2012Allograft vasculopathy vs. coronary artery disease: comparison by opticalcoherence tomographyChristian Templin*, Jelena R. Ghadri, Georg Noll, Thomas F. Lu¨scher, and Frank RuschitzkaDepartment of Cardiology, Cardiovascular Center, University of Zurich, Zurich, Switzerland* Corresponding author: Department of Cardiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland. Tel: +41 44 255 95 85, Fax: +41 44 255 44 01,Email: christian.templin@usz.chThis paper was guest edited by Prof. Brahmajee K. Nallamothu, Department of Internal Medicine, University of Michigan, MI, USAOptical coherence tomography (OCT) is a novelhigh-resolution intravascular imaging techniqueallowing characterization of coronary arteryplaques and evaluation of stent strut coverage. Asa new application, OCT can be also used in allograftvasculopathy as demonstrated by the followingimages.Comparison of OCT and coronary angiographyin a cardiac transplant recipient vs. a patient withcoronary artery disease: OCT image of the left an-terior descending coronary artery in a 72-year-oldpatient 14 years after heart transplantation andcurrent immunosuppressive treatment with tacroli-mus, azathioprine, and prednisone shows awell-defined signal-rich layer indicating concentricintimal hyperproliferation, which is pathognomonicfor allograft vasculopathy (Panel A; see Supplemen-tary material online, Video S1).Optical coherence tomography image in a70-year-old patient with coronary artery diseasedemonstrates a lipid-rich plaque with a large,homogeneous, poorly delineated and signal-poorregion with alternating signal-rich spots reflectingsingle calcifications (Panel B). A signal-rich bandmirrors a thin fibrous cap extending from 6 to9 o’clock. Moreover, non-covered stent struts arewell visualized (Panel B; see Supplementary material online, Video S2).Sole coronary angiography does not allow assessing intraluminal tissue morphology such as allograft vasculopathy (Panel C ) andplaque characterization (Panel D) which both may have important prognostic implication on patient outcome.Supplementary material is available at European Heart Journal online.Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2012. For permissions please email: journals.permissions@oup.comLong-term benefit of ICD therapy after elective device replacement 137

Allograft vasculopathy vs. coronary artery disease: comparison by optical coherence tomography

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