Document Detail


Contemporary concepts in prevention and treatment of cardiac allograft vasculopathy.
MedLine Citation:
PMID:  16686747     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac allograft vasculopathy (CAV), is characterized by heterogeneous proliferative thickening of the vascular intima of the cardiac allograft vasculature. Since its presentation is commonly clinically silent, early diagnosis and preventative therapy are critical. Preventative therapy including optimization of immunosuppressive therapy and treatment of comorbidities associated with CAV progression must be initiated early since most of the intimal thickening occurs during the first year posttransplant. Long-term use of calcineurin inhibitors is associated with a high incidence of chronic renal disease and also contributes to hyperlipidemia and hypertension, all of which may exacerbate CAV. In addition, statins, antihypertensive agents and anti-CMV agents all have demonstrated benefits in reducing CAV. Once established, the limited treatment options include nonpharmacologic interventions such as retransplantation, percutaneous coronary interventions, coronary artery bypass grafting, transmyocardial laser revascularization and heparin-induced/mediated extracorporeal LDL plasmapheresis (HELP). As the use of new assessment tools increases our understanding of this disease, better preventative and treatment strategies are evolving.
Authors:
M R Mehra
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  6     ISSN:  1600-6135     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-11     Completed Date:  2006-10-25     Revised Date:  2007-02-14    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1248-56     Citation Subset:  IM    
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers
Coronary Circulation*
Coronary Disease / pathology,  prevention & control*,  therapy
Heart Transplantation / methods,  physiology*
Humans
Transplantation, Homologous
Chemical
Reg. No./Substance:
0/Biological Markers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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