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心臓移植を受けた患者のサイトメガロウイルス感染は,内皮機能障害と関連しています
Paraskevi Petrakopoulou1, Marion Kübrich, Sinan Pehlivanli
1Medizinische Klinik und Poliklinik I, University Medical Center, Munich-Grosshadern, Germany.
Circulation
|September 15, 2004
まとめ
心臓移植を受けた患者のサイトメガロウイルス (CMV) 感染症は冠動脈内皮機能を低下させ,心血管疾患のリスクを高めます. CMV陽性ドナー心臓のCMV陰性受容者は,より悪い結果と内皮機能不全を示します.
科学分野:
- 心臓病学 心臓病学
- 移植免疫学 移植免疫学
- 感染症 感染症は感染症です.
背景:
- 心臓アロインプラント血管病 (CAV) は,アロインプラント内皮損傷に起因する.
- サイトメガロウイルス (CMV) 感染症は,内皮血管運動応答を妨害することによって,CAVに寄与する可能性があります.
研究 の 目的:
- 心臓移植を受けた患者の冠動脈内皮機能に対するCMV感染の影響を調査する.
- CMVの血清学的状態と感染エピソードとCAVの発達と心血管疾患の相関を図る.
主な方法:
- 183人の心臓移植患者の冠動脈内皮血管運動機能を評価した.
- 移植前の受容者/ドナーのCMV血清と,CMV感染 (CMVpp65Ag+) の記録と相関する機能.
- 分析された心血管事件と死亡は,CMVの血清学的状態に基づいています.
主要な成果:
- CMV陽性心臓のCMV陰性受容者は,より短いイベントフリータイム (8.1対13.3年) を有しました.
- 遠心帯内皮細胞機能は,血清陽性ドナー心臓のCMV-血清陰性受容者において低下した (P<0.01).
- 文書化されたCMV感染は,より顕著な内皮機能不全と時間の経過とともに悪化と相関しています.
結論:
- CMV感染エピソードは,心臓移植受容者の冠動脈内皮機能障害と関連しています.
- CMV陽性ドナー心臓のCMV陰性受容者は,内皮機能が悪化し,心血管疾患の発生率が高くなります.
- CMV感染は,冠動脈内皮機能不全を悪化させることで,アロ移植の失敗を加速する可能性があります.
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