Potena Luciano, Valantine Hannah A
Institute of Cardiology, Academic Hospital S.Orsola-Malpighi, via Massarenti 9, Building 21, 40138 Bologna, Italy.
Endocrinol Metab Clin North Am. 2007 Dec;36(4):965-81; ix. doi: 10.1016/j.ecl.2007.07.012.
Cardiac allograft vasculopathy (CAV) is a major cause of death in patients surviving more than 1 year after heart transplantation. An important cluster of CAV risk factors occurs as a consequence of insulin resistance and manifests as part of the metabolic syndrome. This article summarizes the pathologic features of CAV and reviews the contribution of the major components of insulin resistance in CAV development and progression. It focuses on the few studies that have analyzed the impact of the individual metabolic abnormalities and inflammation and on therapeutic strategies to minimize the clinical manifestation of insulin resistance after heart transplantation.
心脏移植血管病变(CAV)是心脏移植术后存活超过1年患者死亡的主要原因。CAV危险因素的一个重要集群是胰岛素抵抗的结果,并表现为代谢综合征的一部分。本文总结了CAV的病理特征,并综述了胰岛素抵抗的主要成分在CAV发生和发展中的作用。它重点关注了少数分析个体代谢异常和炎症影响的研究,以及旨在尽量减少心脏移植后胰岛素抵抗临床表现的治疗策略。