Division of Cardiology, Department of Medicine, and Texas Transplant Center, University of Texas Medical Branch, Galveston, TX 77555, USA.
Cardiol Rev. 2011 Jan-Feb;19(1):30-5. doi: 10.1097/CRD.0b013e3181fbde2f.
Cardiac allograft vasculopathy (CAV), characterized by diffuse intimal thickening and luminal narrowing in the arteries of the allograft, is the leading cause of morbidity and mortality in cardiac transplant recipients. Many transplant centers perform routine annual surveillance coronary angiography. However, angiography can underdiagnose or miss CAV due to its diffuse nature. Intravascular ultrasound (IVUS) is more sensitive than angiography. IVUS provides not only accurate information on lumen size, but also quantification of intimal thickening, vessel wall morphology, and composition. IVUS has evolved as a valuable adjunct to angiography and the optimal diagnostic tool for early detection. Noninvasive testing such as dobutamine stress echocardiography and nuclear stress test have shown considerable accuracy in diagnosing significant CAV. Computed tomographic imaging and cardiac magnetic resonance imaging are promising new modalities but require further study. This article reviews the diagnostic methods that are currently available.
心脏移植后冠状动脉病（CAV），其特征是移植物动脉的弥漫性内膜增厚和管腔狭窄，是导致心脏移植受者发病率和死亡率的主要原因。许多移植中心进行常规年度监测冠状动脉造影。然而，由于其弥漫性，血管造影术可能会漏诊或误诊 CAV。血管内超声（IVUS）比血管造影术更敏感。IVUS 不仅提供了关于管腔大小的准确信息，还提供了内膜增厚、血管壁形态和组成的定量信息。IVUS 已发展成为血管造影术的重要辅助手段，也是早期发现的最佳诊断工具。多巴酚丁胺负荷超声心动图和核负荷试验等非侵入性检查在诊断严重 CAV 方面显示出相当高的准确性。计算机断层扫描成像和心脏磁共振成像都是很有前途的新方法，但需要进一步研究。本文综述了目前可用的诊断方法。
