Cardiac allograft vasculopathy screening
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Cardiac allograft vasculopathy Microchapters |
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Differentiating Cardiac allograft vasculopathy from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Cardiac allograft vasculopathy screening On the Web |
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American Roentgen Ray Society Images of Cardiac allograft vasculopathy screening |
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Directions to Hospitals Treating Cardiac allograft vasculopathy |
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Risk calculators and risk factors for Cardiac allograft vasculopathy screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2] Raviteja Guddeti, M.B.B.S. [3]
Overview
Cardiac allograft vasculopathy (CAV) is the leading cause of morbidity and mortality beyond the first year in heart transplant recipients. In most cardiac transplant centers coronary angiography currently remains the screening tool of choice for CAV. Early diagnosis is important as it may allow for alterations in medical therapy before the disease progresses to the stage where revascularization is required. Studies have shown that changes in immunosuppressive therapy may delay the progression of CAV or may even lead to regression [1] [2].
Screening
The 2010 International Society of Heart and Lung Transplant Guidelines for the care of heart transplant recipients recommend annual invasive coronary angiography as the screening tool of choice for CAV.[3] In most centers screening of graft coronary arteries for signs of CAV is usually performed six weeks after cardiac transplantation and then annually thereafter. In a retrospective study by Haddad et al it was reported that angiographic evidence of CAV increases by approximately 10% with every 2-year period after cardiac transplantation.[4]
References
- ↑ Mancini D, Pinney S, Burkhoff D, LaManca J, Itescu S, Burke E; et al. (2003). "Use of rapamycin slows progression of cardiac transplantation vasculopathy". Circulation. 108 (1): 48–53. doi:10.1161/01.CIR.0000070421.38604.2B. PMID 12742978.
- ↑ Lamich R, Ballester M, Martí V, Brossa V, Aymat R, Carrió I; et al. (1998). "Efficacy of augmented immunosuppressive therapy for early vasculopathy in heart transplantation". J Am Coll Cardiol. 32 (2): 413–9. PMID 9708469.
- ↑ Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S; et al. (2010). "The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients". J Heart Lung Transplant. 29 (8): 914–56. doi:10.1016/j.healun.2010.05.034. PMID 20643330.
- ↑ Haddad M, Pflugfelder PW, Guiraudon C, Novick RJ, McKenzie FN, Menkis A; et al. (2005). "Angiographic, pathologic, and clinical relationships in coronary artery disease in cardiac allografts". J Heart Lung Transplant. 24 (9): 1218–25. doi:10.1016/j.healun.2004.08.016. PMID 16143236.