Muñoz Aguilera R, García Robles J A, Palomo Alvarez J, Botas Rodríguez J
Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid.
Rev Esp Cardiol. 1995;48 Suppl 7:115-28.
Transplant coronary artery disease (EVI) is still the leading cause of late mortality in cardiac transplant patients. The pathogenesis is not determined yet. Probably the basic mechanism is immunological but the subsequent development and progression of the disease depend on the interaction of immunological and nonimmunological factors. Its typical diffuse morphology and its behavior make difficult the diagnosis with non invasive methods. Coronary angiography is not sensitive for an early diagnosis of EVI but its detection has prognostic value. Intracoronary ultrasound (IVUS) is very sensitive to detect angiographically silent lesions, and has correlated well with histological findings. Its prognostic value is still being evaluated. More studies are needed to establish the usefulness of endothelial dysfunction and coronary flow reserve tests in the evaluation of EVI.
移植冠状动脉疾病（EVI）仍是心脏移植患者晚期死亡的主要原因。其发病机制尚未明确。基本机制可能是免疫性的，但疾病随后的发展和进展取决于免疫和非免疫因素的相互作用。其典型的弥漫性形态及其表现使得采用非侵入性方法进行诊断较为困难。冠状动脉造影对EVI的早期诊断并不敏感，但其检测具有预后价值。血管内超声（IVUS）对检测血管造影隐匿性病变非常敏感，且与组织学结果相关性良好。其预后价值仍在评估中。需要更多研究来确定内皮功能障碍和冠状动脉血流储备测试在评估EVI中的实用性。
