Clerkin Kevin J, Ali Ziad A, Mancini Donna M
aDepartment of Medicine, Division of Cardiology, Columbia University Medical Center bCardiovascular Research Foundation cDepartment of Medicine, Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, USA.
Curr Opin Cardiol. 2017 May;32(3):316-325. doi: 10.1097/HCO.0000000000000388.
Cardiac allograft vasculopathy (CAV) is a major limitation to long-term survival after heart transplantation. Innovative new techniques to diagnose CAV have been applied to detect disease. This review will examine the current diagnostic and treatment options available to clinicians for CAV.
Diagnostic modalities addressing the pathophysiology underlying CAV (arterial wall thickening and decreased coronary blood flow) improve diagnostic sensitivity when compared to traditional (angiography and dobutamine stress echocardiography) techniques.
Limited options are available to prevent and treat CAV; however, progress has been made in making an earlier and more accurate diagnosis. Future research is needed to identify the optimal time to modify immunosuppression and investigate novel treatments for CAV.
心脏移植术后同种异体移植物血管病变(CAV)是长期生存的主要限制因素。已应用创新新技术来诊断CAV以检测疾病。本综述将探讨临床医生目前可用于CAV的诊断和治疗选择。
与传统(血管造影和多巴酚丁胺负荷超声心动图)技术相比,针对CAV潜在病理生理学(动脉壁增厚和冠状动脉血流减少)的诊断方法可提高诊断敏感性。
预防和治疗CAV的选择有限;然而,在更早、更准确的诊断方面已取得进展。需要未来的研究来确定调整免疫抑制的最佳时机,并研究CAV的新治疗方法。