Progression of cardiac allograft vasculopathy assessed by serial three-vessel quantitative coronary angiography.

BACKGROUND: The purpose of the present study was to assess the short- and long-term progression of cardiac allograft vasculopathy (CAV) using serial 3-vessel quantitative coronary angiography (QCA). METHODS: CAV progression was assessed using serial 3-vessel QCA analysis at baseline, 1-year and long-term angiographic follow-up (8.5±3.7 years) after heart transplantation. The change in minimal lumen diameter (MLD) and percent diameter stenosis (%DS) was serially assessed within matched segments. Patients were graded according to the ISHLT-CAV classification and grouped as ISHLT-CAV0 and ISHLT-CAV1-3. The primary endpoint was mean change in MLD and %DS. RESULTS: A total of 41 patients and 520 matched segments were available for serial 3-vessel QCA. Overall, MLD decreased non-significantly from baseline to 1-year follow-up and significantly from 1-year to the long-term angiographic follow-up (Δ-0.08mm/year [95%CI -0.11 to -0.05], P<0.001). %DS increased significantly from baseline to 1-year (Δ+0.96%/year [95%CI 0.04 to 1.88], P = 0.041) and from 1-year to long-term angiographic follow-up (Δ+0.61%/year [95%CI 0.33 to 0.88], P<0.001). ISHLT-CAV1-3 at 1 year and at long-term angiographic follow-up was observed in 22% and 61%, respectively. Between baseline and long-term angiographic follow-up, a significant reduction in MLD was observed within both groups without a significant difference in the reduction between the two groups (ISHLT-CAV0: median -0.49mm [IQR -0.54 to -0.43] vs. ISHLT-CAV1-3: median -0.40mm [IQR -0.44 to -0.35], P = 0.4). CONCLUSION: The current data suggest that QCA can't predict CAV beyond 1 year, but, QCA affirmed that CAV progresses to a similar extent in patients who do not develop visual CAV during long-term follow-up.

Strategic use of number representation is independent of test instruction in random number generation.

The effects of different instructions on verbal random number generation were examined in 40 healthy students who attempted to generate random sequences of the digits 1 to 6. Two groups of 20 received different instructions with alternative numerical representations. The Symbolic group (Arabic digits) was instructed to randomize while continuously using the analogy of selecting and replacing numbered balls from a hat, whereas the Nonsymbolic group (arrays of dots) was instructed to imagine repeatedly throwing a die. Participants asked for self-reports on their strategies reported spontaneously occurring visuospatial imagination of a mental number line (42%), or imagining throwing a die (23%). Individual number representation was not affected by the initial instruction. There were no differences in randomization performance by group. Comprehensive understanding of the nature of the randomization task requires considering individual differences in construction of mental models.