Haji Showkat A, Avery Robin K, Yamani Mohamad H, Tuzcu E Murat, Crowe Timothy D, Cook Daniel J, Mawhorter Steven D, Hobbs Robert, Young James B, Smedira Nicholas, Starling Randall C
Department of Cardiology, Tulane University Medical Center, New Orleans, Louisiana 70112, USA.
J Heart Lung Transplant. 2006 Mar;25(3):294-7. doi: 10.1016/j.healun.2005.10.007. Epub 2006 Jan 6.
Increasing interest has focused on possible viral triggers of cardiac allograft vasculopathy. Although much interest has centered on cytomegalovirus, it has recently been noted that donor hepatitis C seropositivity is associated with risk for accelerated vasculopathy. The current study hypothesized that hepatitis B (HBV) might be associated with accelerated vasculopathy.
Sixty-six patients who received heart transplants between September 1998 and July 2000 were analyzed by intravascular ultrasound within 6 weeks and again at 12 months after transplantation. These patients were divided into 2 groups: the HBV Group (n = 13) in which either the donor or recipient was seropositive for hepatitis B core antibody (HBcAb), and a Control Group (n = 53) in which neither donor nor recipient was positive for HBcAb.
Baseline characteristics of the 2 groups were similar. The HBV Group had significant increase in the change in average intimal area (1.59 +/- 1.4 vs 0.46 +/- 0.4 mm2, p = 0.01) per mm length of the vessel compared with controls. Allograft vasculopathy at 1 year (defined as largest maximal intimal thickness increase of > or =0.50 mm) occurred in 46% of the HBV group compared with 24% of the control group (p = 0.05). When measured as an average maximal intimal thickness increase of >0.30 mm, allograft vasculopathy at 1 year occurred in 31% of the HBV Group compared with 5% of Controls (p = 0.01).
These preliminary results suggest that HBV seropositivity in donor or recipient may be associated with an increased risk for cardiac allograft vasculopathy.
人们越来越关注心脏移植血管病变可能的病毒触发因素。尽管很多研究都集中在巨细胞病毒上，但最近有研究指出，供体丙型肝炎血清学阳性与加速血管病变的风险相关。当前研究推测，乙型肝炎（HBV）可能与加速血管病变有关。
对1998年9月至2000年7月间接受心脏移植的66例患者在移植后6周内及12个月时进行血管内超声检查。这些患者被分为两组：HBV组（n = 13），供体或受体乙肝核心抗体（HBcAb）血清学阳性；对照组（n = 53），供体和受体HBcAb均为阴性。
两组的基线特征相似。与对照组相比，HBV组血管每毫米长度的平均内膜面积变化显著增加（1.59 ± 1.4 vs 0.46 ± 0.4 mm²，p = 0.01）。HBV组1年时发生移植血管病变（定义为最大内膜厚度增加≥0.50 mm）的比例为46%，而对照组为24%（p = 0.05）。以平均最大内膜厚度增加>0.30 mm衡量时，HBV组1年时发生移植血管病变的比例为31%，而对照组为5%（p = 0.01）。
这些初步结果表明，供体或受体HBV血清学阳性可能与心脏移植血管病变风险增加有关。
