
Cardiac allograft vasculopathy (CAV) compromises myocardial blood flow (MBF) and increases cardiovascular risks in heart transplant (HT) recipients. This retrospective study evaluated the association of CAV and reduced MBF (RMBF) with donor-derived cell-free DNA (dd-cfDNA) levels in 256 HT recipients. The results revealed no significant differences in dd-cfDNA levels between patients with and without angiographic CAV. However, dd-cfDNA levels were markedly higher in patients with RMBF (≤2 MBF reserve) compared to those with normal MBF. These findings suggest that while angiographic CAV may not correlate with dd-cfDNA elevation, RMBF is significantly associated with increased dd-cfDNA, highlighting its potential as a biomarker for impaired MBF.
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