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学科主题: 临床医学
题名:
Influence of pre-existing donor atherosclerosis on the development of cardiac allograft vasculopathy and outcomes in heart transplant recipients
作者: Li, H; Tanaka, K; Anzai, H; Oeser, B; Lai, D; Kobashigawa, IA; Tobis, JM
刊名: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
发表日期: 2006-06-20
DOI: 10.1016/j.jacc.2006.01.072
卷: 47, 期:12, 页:2470-2476
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: CORONARY-ARTERY-DISEASE ; SERIAL INTRAVASCULAR ULTRASOUND ; MYCOPHENOLATE-MOFETIL ; LUNG-TRANSPLANTATION ; CONTROLLED-TRIAL ; PROGRESSION ; MORTALITY ; REGISTRY ; ANGIOGRAPHY ; REJECTION
英文摘要:

OBJECTIVES This study sought to evaluate the influence of donor lesions on the development of cardiac allograft vasculopathy and outcomes in heart transplant recipients.

BACKGROUND After orthotopic heart transplantation (OHT), coronary artery narrowing occurs as a combination of pre-existing donor lesions and new lesions that develop as a result of cardiac allograft vasculopathy.

METHODS Intravascular ultrasound (IVUS) studies were performed in 301 recipients at 1.3 +/- 0.6 months and again at 12.2 +/- 0.8 months after OHT. Additional IVUS studies were performed in 90 patients at two and three years of follow-up. Sites at baseline with maximum intimal thickness >= 0.5 mm were defined as pre-existing donor lesions. The angiographic diagnosis of transplant coronary artery disease (TCAD) was defined as a new >= 50% diameter narrowing of a major epicardial vessel.

RESULTS Donor lesions were present in 30% of the hearts. By IVUS, sites with donor lesions did not have a greater increase in intimal area compared with sites without donor lesions. Angiographically, the incidence of TCAD up to three years after transplantation was higher in recipients with donor lesions than in recipients without donor lesions (25% vs. 4%, p < 0.001). However, the three-year mortality rate was similar between recipients with or without donor lesions (4.5% vs. 5.2%, p = 1.0).

CONCLUSIONS Pre-existing donor lesions do not act as a nidus for accelerating the progression of intimal hyperplasia. However, patients with donor lesions have a higher incidence of angiographic TCAD. Donor lesions do not affect the long-term survival of patients with OHT up to three years.

语种: 英语
WOS记录号: WOS:000238337500017
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/61169
Appears in Collections:北京大学第三临床医学院_心血管内科_期刊论文

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作者单位: 1.Univ Calif Los Angeles, Med Ctr, Div Cardiol, David Geffen Sch Med,Dept Med, Los Angeles, CA 90095 USA
2.Peking Univ, Hosp 3, Dept Cardiol, Beijing 100871, Peoples R China

Recommended Citation:
Li, H,Tanaka, K,Anzai, H,et al. Influence of pre-existing donor atherosclerosis on the development of cardiac allograft vasculopathy and outcomes in heart transplant recipients[J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY,2006,47(12):2470-2476.
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