Mehra M R, Ventura H O, Smart F W, Stapleton D D, Collins T J, Ramee S R, Murgo J P, White C J
Department of Cardiology, Ochsner Medical Institutions, New Orleans, LA 70121, USA.
Tex Heart Inst J. 1995;22(2):138-44.
The major cause of late death in cardiac transplant recipients is cardiac allograft vasculopathy, also referred to as cardiac transplant atherosclerosis, which occurs in as many as 45% of transplant recipients who survive longer than 1 year. It differs from typical atherosclerosis in that intimal hyperplasia is concentric and diffuse, the internal elastic lamina remains intact, calcification is rare, and the disease tends to develop rapidly. Intravascular ultrasound and coronary angioscopy are more sensitive diagnostic measures of cardiac allograft vasculopathy than is coronary angiography. Although retransplantation at present seems to be the only definitive therapy for cardiac allograft vasculopathy, it has shown only fair results. Recent studies have suggested that calcium entry blockers and angiotensin-converting enzyme inhibitors may play a beneficial role in delaying the progression of cardiac allograft vasculopathy.
心脏移植受者晚期死亡的主要原因是心脏移植血管病变，也称为心脏移植动脉粥样硬化，在存活超过1年的移植受者中，高达45%的人会出现这种情况。它与典型的动脉粥样硬化不同，内膜增生是同心性和弥漫性的，内弹性膜保持完整，钙化罕见，且该疾病往往发展迅速。血管内超声和冠状动脉血管镜检查对心脏移植血管病变的诊断比冠状动脉造影更敏感。虽然目前再次移植似乎是治疗心脏移植血管病变的唯一确定性疗法，但效果并不理想。最近的研究表明，钙通道阻滞剂和血管紧张素转换酶抑制剂可能在延缓心脏移植血管病变的进展中发挥有益作用。
