Lietz Katherine, Miller Leslie W
Cardiovascular Division, University of Minnesota, Minneapolis, MN 55455, USA.
Semin Thorac Cardiovasc Surg. 2004 Winter;16(4):386-94. doi: 10.1053/j.semtcvs.2004.09.004.
Cardiac allograft vasculopathy (CAV) is the major obstacle to long-term survival after heart transplantation. It is a rapidly progressive, obliterative form of coronary vasculopathy distinct from classic atheromatous disease. The pathogenesis is most likely multifactorial and involves both alloantigen dependent and independent mechanisms. Since there is no definitive treatment for CAV and new immunosuppressive agents can only slow the progression of this disease, the prophylaxis and modification of numerous risk factors remains the foundation of posttransplant management in the heart transplant recipient. In this review, we discuss current understanding of the pathogenesis of CAV, novel diagnostic and therapeutic avenues and explore optimal approaches to risk factors modification.
心脏移植血管病变（CAV）是心脏移植后长期存活的主要障碍。它是一种快速进展的闭塞性冠状动脉病变，有别于典型的动脉粥样硬化疾病。其发病机制很可能是多因素的，涉及同种抗原依赖性和非依赖性机制。由于CAV尚无确切的治疗方法，新型免疫抑制剂只能减缓该病的进展，因此对众多危险因素的预防和控制仍是心脏移植受者移植后管理的基础。在本综述中，我们讨论了目前对CAV发病机制的认识、新的诊断和治疗途径，并探讨了控制危险因素的最佳方法。
