Study on the Relationship Between Coronary Microcirculatory Dysfunction and Heart Transplant Prognosis After Heart Transplantation


Acute cellular rejection after transplantation, which is crucial for the prognosis of heart transplant patients, occurs in 13-30% of patients despite the development of modern surgical techniques and immunosuppressive therapy. The current standard treatment guideline is to diagnose through myocardial biopsy, and after diagnosis, strong immunosuppressive therapy would be used to block transplant rejection. However, myocardial biopsy can diagnose rejection only after confirming damage to the heart muscle after transplant rejection.


The Coronary Intervention team and the Heart Failure-Heart Transplant Team at Heart Vascular Stroke Institute SMC conducted a physiological examination of the coronary arteries under the hypothesis that a decrease in coronary microcirculatory function of the heart muscle would occur before myocardial tissue damage became evident in the event of heart transplant rejection. Since 2016, a prospective registry study of heart transplant patients was conducted to evaluate whether measuring the coronary microcirculatory dysfunction would improve the prediction of heart transplant rejection.


The research team confirmed that the risk of rejection after heart transplantation increased by more than 15 times in patients with an increased Index of Microcirculatory Resistance measured through a physiological examination of the coronary artery within 1 month after transplantation. Furthermore, the rejection has also been reported to be associated with the development of cardiac allograft vasculopathy [CAV], and the results of this study were published in Circulation.