open access

Vol 12, No 1 (2017)
Review Papers
Published online: 2016-09-10
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Cardiac allograft vasculopathy — new trends in diagnostics and treatment

Maria Milczarek, Małgorzata Wojciechowska, Artur Mamcarz, Agnieszka Cudnoch-Jędrzejewska
DOI: 10.5603/FC.a2016.0066
·
Folia Cardiologica 2017;12(1):50-54.

open access

Vol 12, No 1 (2017)
Review Papers
Published online: 2016-09-10

Abstract

Cardiac allograft vasculopathy (CAV) is one of the most significant complications in heart transplant patients. It is mentioned among three most frequent causes of death in patients over 3 years after heart transplant. It is an accelerated form of atherosclerosis with complex pathogenesis, including immunological reactions and viral infections. Classical atherosclerosis risk factors tend to influence the progress of CAV in the later stage. Due to nonspecific symptoms, diagnostic imaging is of a great value in recognizing CAV. Apart from angiography, which is the “gold standard” in diagnostics, modern imaging is increasingly gaining in importance. Intravascular ultrasound and its connection with virtual histology, as well as optical coherence tomography enable an accurate measurement of maximal intimal thickness (MIT), which is a prognostic factor of CAV progression. Moreover, these methods make it possible to assess the structure of plaques and to distinguish between CAV and atherosclerotic plaques. There are still researches conducted to find out the most favorable connections of immunosuppresive and antiproliferative drugs, which are the basis of CAV prevention and treatment. It has been observed that the effect of treatment differs depending on the used scheme. Apart from pharmacological treatment, angioplasty or coronary artery bypass graft can be profitable in some patients. The main goals of CAV researches are early diagnostics possibilities and effective suppression of this dangerous pathology progression.

Abstract

Cardiac allograft vasculopathy (CAV) is one of the most significant complications in heart transplant patients. It is mentioned among three most frequent causes of death in patients over 3 years after heart transplant. It is an accelerated form of atherosclerosis with complex pathogenesis, including immunological reactions and viral infections. Classical atherosclerosis risk factors tend to influence the progress of CAV in the later stage. Due to nonspecific symptoms, diagnostic imaging is of a great value in recognizing CAV. Apart from angiography, which is the “gold standard” in diagnostics, modern imaging is increasingly gaining in importance. Intravascular ultrasound and its connection with virtual histology, as well as optical coherence tomography enable an accurate measurement of maximal intimal thickness (MIT), which is a prognostic factor of CAV progression. Moreover, these methods make it possible to assess the structure of plaques and to distinguish between CAV and atherosclerotic plaques. There are still researches conducted to find out the most favorable connections of immunosuppresive and antiproliferative drugs, which are the basis of CAV prevention and treatment. It has been observed that the effect of treatment differs depending on the used scheme. Apart from pharmacological treatment, angioplasty or coronary artery bypass graft can be profitable in some patients. The main goals of CAV researches are early diagnostics possibilities and effective suppression of this dangerous pathology progression.

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Keywords

CAV, atherosclerosis, heart transplant, vasculopathy

About this article
Title

Cardiac allograft vasculopathy — new trends in diagnostics and treatment

Journal

Folia Cardiologica

Issue

Vol 12, No 1 (2017)

Pages

50-54

Published online

2016-09-10

DOI

10.5603/FC.a2016.0066

Bibliographic record

Folia Cardiologica 2017;12(1):50-54.

Keywords

CAV
atherosclerosis
heart transplant
vasculopathy

Authors

Maria Milczarek
Małgorzata Wojciechowska
Artur Mamcarz
Agnieszka Cudnoch-Jędrzejewska

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