Capabilities of intravascular imaging techniques in the diagnosis of cardiac allograft vasculopathy: Literature review

Cardiac allograft vasculopathy (CAV) is a coronary heart disease (CHD), arising after an orthotopic heart transplant (OHT), and it is one of the leading causes of death in heart recipients. The probability of death is 10%. CAV can manifest as early as 1 year after OHT. Patients do not have pain syndrome that is typical for CHD due to cardiac denervation. The first clinical manifestations may be congestive heart failure, ventricular arrhythmias or even sudden cardiac death. Coronary angiography is the routine technique for CAV detection. However, it is not sensitive enough (about 44%) for CAV detection at an early stage of the disease. Today, intravascular imaging methods (intravascular ultrasound, optical coherence tomography), which allow the evaluation of the morphology of coronary artery lesions, including CAV, have become widespread. This article is devoted to the modern capabilities of intravascular imaging methods in the diagnosis of CAV. CAV is the main cause of myocardial infarction and chronic heart failure in patients after OHT. Intravascular imaging techniques allow early detection of this condition and prevention of unfavorable outcomes in a complex category of heart recipients. Given the advantages of optical coherence tomography (OCT) and disadvantages of intravascular ultrasound (IVUS), OCT appears to be a more informative method of CAV detection.