Analysis of the risk factors for allograft vasculopathy in asymptomatic patients after cardiac transplantation

Bacal, Fernando; Veiga, Viviane Cordeiro; Fiorelli, Alfredo Inácio; Bellotti, Giovanni; Bocchi, Edimar Alcides; Na, Stolf; Ramires, José Antônio Franchini

doi:10.1590/s0066-782x2000001100006

Cited by 14 publications

(14 citation statements)

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“…In a previous study, we also documented the influence of this factor in the development of CAV. 4 Body mass index may be much more than an anthropometric index and may reflect a metabolic disorder that occurs in some patients after heart transplantation. Insulin resistance is a marker of cardiovascular events in the atherosclerotic process, but this concept is not well established in heart transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“…We and others have reported that up to 10% of patients in the 1st year and up to 50% of patients in the 5th year of follow-up after heart transplantation have evidence of CAV in coronary arteriograms. 4 Clinically, this disease is insidious and usually gives no clues until heart failure, myocardial infarction, or death occurs. [5][6][7][8] Nevertheless, routine evaluation with coronary angiography, thrombolysis in myocardial infarction frame counts, and intravascular ultrasound is undesirable because these tests are invasive, expensive, not without risk, and sometimes inaccurate.…”

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confidence: 99%

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Dobutamine stress echocardiography predicts cardiac events or death in asymptomatic patients long-term after heart transplantation: 4-Year prospective evaluation

Bacal

Moreira

Souza

et al. 2004

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Dobutamine stress echocardiography predicts cardiac events or death in asymptomatic patients long-term after heart transplantation: 4-Year prospective evaluation

Bacal

Moreira

Souza

et al. 2004

The Journal of Heart and Lung Transplantation

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“…However, it seems to be low, less than 10% of the patients undergoing CT 280,297,320 . For the purpose of diagnosis and prevention, the same methods used for other etiologies are recommended [321][322][323][324] .…”

Section: Graft Coronary Artery Diseasementioning

confidence: 99%

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

Castro¹,

Andrade²,

Vilas-Boas³

et al. 2011

Arq. Bras. Cardiol.

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“…Despite achieving significant strides in short term survival, the challenges of long-term survival remain unresolved. Chronic rejection, cardiac allograft vasculopathy (CAV), malignancy and renal insufficiency hinder the long-term survival and are direct contributors to graft dysfunction and graft failure [1][2][3][4][5]. CAV remains one of the major causes of mortality and morbidity following the first year of cardiac transplantation [1,2].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Allograft Vasculopathy: A Review of Risk Factors and Pathogenesis

Munagala¹,

Phancao²

2018

obm.transplant

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Heart transplant remains the gold standard therapy for patients with end stage heart disease and offers improved survival and quality of life. Significant progress has been achieved in improving one-year mortality after heart transplantation. Nonetheless, longterm graft survival has not changed significantly over the past few decades. Long term survival of heart transplant recipients is limited by chronic rejection, cardiac allograft vasculopathy (CAV), and malignancy. CAV is a major contributor for graft failure and mortality after the first year of in heart transplant recipients. CAV is a proliferative vasculopathy characterized by diffuse myointimal hyperplasia and progressive narrowing of the graft vessels. Both immune dependent and independent factors have been shown to contribute to the pathogenesis of CAV. Understanding these risk factors is essential in developing preventative and therapeutic strategies. Angiography with Intravascular ultrasound has become the key diagnostic tool in the early detection of CAV as well as prognostication. Echocardiographic assessment of allograft function in conjunction with coronary angiographic findings are used in assessing the severity of CAV. Adjustment of immunosuppression and statins remain the initial steps in the management of CAV. Retransplantation is the definitive treatment for severe CAV, however, the paucity of organs along with increased mortality associated with retransplantation makes it a less desirable option. Remarkable progress has been achieved in the understanding of pathogenesis, risk factors for CAV and plaque morphology. Nevertheless, significant knowledge gaps persist in scientific understanding of risk factors, pathogenesis, prevention and treatment of CAV. Further research is warranted to fill these gaps, develop diagnostic modalities to facilitate early detection of CAV, and management strategies to Improve graft tolerance and immune modulation. This review focuses on summarizing the pathogenesis and risk factors for CAV.

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Analysis of the risk factors for allograft vasculopathy in asymptomatic patients after cardiac transplantation

Cited by 14 publications

References 30 publications

Dobutamine stress echocardiography predicts cardiac events or death in asymptomatic patients long-term after heart transplantation: 4-Year prospective evaluation

Dobutamine stress echocardiography predicts cardiac events or death in asymptomatic patients long-term after heart transplantation: 4-Year prospective evaluation

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

Cardiac Allograft Vasculopathy: A Review of Risk Factors and Pathogenesis

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