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心脏移植后冠状动脉内皮功能障碍预测了所有移植血管病变和心脏死亡

S M Hollenberg¹, L W Klein, J E Parrillo

¹Section of Cardiology, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois, USA.

|December 19, 2001

概括

心脏移植接受者的内皮功能障碍预测了未来的心脏事件,如死亡或心脏全移植血管病变 (CAV). 序列内皮功能测试可以识别有风险的患者.

科学领域:

心脏病学心脏病学
移植医学移植医学移植医学
血管生物学血管生物学

背景情况:

冠状动脉内皮功能障碍是心脏移植接受者心脏异位血管病变 (CAV) 的早期指标.
之前的研究表明,每年内皮功能下降与内皮增厚有关.

研究的目的:

为了确定内皮功能障碍是否预测临床事件,包括心脏死亡和CAV发展.
评估串行内皮功能测量的预测值.

主要方法:

七十三名心脏移植患者每年在移植后进行监测.
冠状动脉内皮功能使用冠状动脉内注射乙胆,腺和酸甘油进行评估.
血管内超声波和多普勒速度同时测量以评估表心和微血管反应.

主要成果:

在研究期间,有14名患者达到终点 (CAV或心脏死亡).
具有终点的患者与没有终点的患者相比,对乙胆的内皮依赖性心脏和微血管反应显著受损.
对腺和酸甘油的反应在各组之间没有显著差异.

结论:

异常的乙胆反应,表明内皮功能障碍,先于心脏移植接受者的临床终点.
内皮功能障碍与临床显著的心脏移植血管病变的发展有关.
内皮功能的连续评估对心脏移植患者的风险分层具有临床实用性.

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