Bae Jang-Ho, Rihal Charanjit S, Edwards Brooks S, Kushwaha Sudhir S, Mathew Verghese, Prasad Abhiram, Holmes David R, Lerman Amir
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
Transplantation. 2006 Oct 27;82(8):1108-11. doi: 10.1097/01.tp.0000230378.61437.a5.
We assessed clinical predictors of the process of cardiac allograft vasculopathy (CAV) in 39 consecutive patients (mean 49 years old) using three-dimensional intravascular ultrasound (3-D IVUS) examination of the left anterior descending coronary artery at 36 +/- 38 months and 47 +/- 40 months after cardiac allotransplantation (TX). Compared with 17 patients with plaque progression, 22 patients with plaque regression were more likely to be male (P < .01), to have a higher use of angiotensin-converting enzyme inhibitors (ACEI, P < .05), and to have a lower volumetric remodeling index (P < .001). The changes in plaque volume correlated with the changes in total cholesterol (P < .005) and low-density lipoprotein cholesterol (P < .02). Plaque progression of CAV was independently associated with time after TX, hypertension, nonuse of ACEI, donor age, and changes in total cholesterol and triglycerides. In conclusion, plaque progression is associated with positive vascular remodeling and plaque regression is associated with lower serum lipids and ACEI in patients after TX.
我们对39例连续患者（平均年龄49岁）进行了评估，在心脏同种异体移植（TX）后36±38个月和47±40个月时，使用三维血管内超声（3-D IVUS）检查左前降支冠状动脉，以确定心脏移植血管病变（CAV）进程的临床预测因素。与17例斑块进展患者相比，22例斑块消退患者更可能为男性（P<.01），使用血管紧张素转换酶抑制剂（ACEI）的比例更高（P<.05），且体积重塑指数更低（P<.001）。斑块体积的变化与总胆固醇（P<.005）和低密度脂蛋白胆固醇（P<.02）的变化相关。CAV的斑块进展与TX后的时间、高血压、未使用ACEI、供体年龄以及总胆固醇和甘油三酯的变化独立相关。总之，TX后患者的斑块进展与阳性血管重塑相关，而斑块消退与较低的血脂水平和ACEI使用相关。
