Prospektive Untersuchung von Häufigkeit und Ausmaß spenderbedingter koronarer Herzkrankheit nach Herztransplantation mit intravaskulärem Ultraschall
| Autor: | Christoph H. Spes, Johannes Rieber, Karl Theisen, Volker Klauss, Harald Mudra, Uwe Siebert, Bruno Meiser, Christiane E. Angermann, K.-H. Henneke |
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| Rok vydání: | 2008 |
| Předmět: |
Heart transplantation
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment General Medicine Coronary disease medicine.disease Coronary arteries Coronary artery disease medicine.anatomical_structure Internal medicine Predictive value of tests Intravascular ultrasound Angiography medicine Cardiology Radiology business Prospective cohort study |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 122:1235-1241 |
| ISSN: | 1439-4413 0012-0472 |
| Popis: | Problem and objective Cardiac allograft vasculopathy influences long-term survival of patients after heart transplantation. Donor-transmitted coronary artery disease may contribute to the further development of cardiac allograft vasculopathy. The aim of this study was to characterize by intracoronary ultrasound the extent and frequency of transmitted coronary artery disease. Patients and methods Intravascular ultrasound studies were performed at routine angiography in 33 patients (26 men, 7 women, mean age 51 [23-69] years) early after heart transplantation. Plaque morphology was analysed in 153 coronary segments of 52 epicardial coronary arteries. Results Relevant atherosclerosis (defined as maximal plaque thickness > or = 0.5 mm in at least one coronary segment) was found in 17 patients (52%), while angiography showed irregularities in only 7 patients (21%). Maximal plaque thickness in patients with relevant atherosclerosis was 1.13 +/- 0.32 mm, mean plaque index was 19.2 +/- 10.2%. Plaque formation was eccentric, and plaques were predominantly located in proximal segments. Morphologic changes affecting more than one segment were found in 52% of the patients. Comparing clinical factors, only donor age predicted the degree of atherosclerosis. Conclusions In more than one half of the patients studied early after heart transplantation, Intravascular ultrasound revealed epicardial atherosclerotic lesions which were incompletely identified by coronary angiography. The degree of atherosclerosis was closely related to donor age. The potential influence of donor transmitted coronary artery disease on the progression of transplant coronary artery disease requires further longitudinal studies. |
| Databáze: | OpenAIRE |
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