Cardiac Allograft Vasculopathy: Challenges and Advances in Invasive and Non-Invasive Diagnostic Modalities

被引:1
|
作者
Kamel, Moaz A. [1 ]
Scalia, Isabel G. [1 ]
Badr, Amro T. [1 ]
Ali, Nima Baba [1 ]
Farina, Juan M. [1 ]
Pereyra, Milagros [1 ]
Abbas, Mohammed Tiseer [1 ]
Mahmoud, Ahmed K. [1 ]
Scott, Robert L. [1 ]
Steidley, David E. [1 ]
Rosenthal, Julie L. [1 ]
Lemond, Lisa M. [1 ]
Sell-Dottin, Kristen A. [2 ]
Hardaway, Brian W. [1 ]
Barry, Timothy [1 ]
Yang, Ming [3 ]
Chao, Chieh-Ju [4 ]
Jokerst, Clinton E. [3 ]
Ayoub, Chadi [1 ]
Arsanjani, Reza [1 ]
机构
[1] Dept Cardiovasc Med, Mayo Clin, Phoenix, AZ 85054 USA
[2] Dept Cardiothorac Surg, Mayo Clin, Phoenix, AZ 85054 USA
[3] Dept Radiol, Mayo Clin, Phoenix, AZ 85054 USA
[4] Dept Cardiovasc Med, Mayo Clin, Rochester, MN 55905 USA
关键词
cardiac allograft vasculopathy; angiography; echocardiography; nuclear imaging; HEART-TRANSPLANT RECIPIENTS; MYOCARDIAL-PERFUSION RESERVE; DOBUTAMINE STRESS ECHOCARDIOGRAPHY; OPTICAL COHERENCE TOMOGRAPHY; POSITRON-EMISSION-TOMOGRAPHY; CORONARY COMPUTED-TOMOGRAPHY; FRACTIONAL FLOW RESERVE; PROGNOSTIC VALUE; INTRAVASCULAR ULTRASONOGRAPHY; INTERNATIONAL SOCIETY;
D O I
10.3390/jcdd11030095
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity. However, these tests are invasive and are unable to visualize and evaluate coronary microcirculation. Increasing evidence for non-invasive surveillance techniques assessing both epicardial and microvascular components of CAV may help improve early detection. These include computed tomography coronary angiography (CTCA), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and vasodilator stress myocardial contrast echocardiography perfusion imaging. This review summarizes the current state of diagnostic modalities and their utility and prognostic value for CAV and also evaluates emerging tools that may improve the early detection of this complex disease.
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页数:22
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