Cardiac allograft vasculopathy: an update.
Allograft vasculopathy remains the nemesis of long-term survival in heart transplantation. Possible modifying risk factors such as obesity, diabetes, and hypertension should continue to be pursued aggressively. All patients should receive statins. Clinical trials will provide the evidence needed to ascertain whether mammalian target of rapamycin inhibitors should be used in de novo cardiac transplant recipients to attenuate cardiac allograft vasculopathy (CAV). Intravascular ultrasound appears to play a key role in the diagnosis and evaluation of new treatments, and may indeed represent a surrogate marker that can be used to tailor management and improve outcomes. A better understanding of CAV is needed to develop targeted preventive therapies. Ongoing research in native atherosclerosis and vascular biology may provide answers within the next decade.
Sipahi
Ilke
I
Kaufman Center for Heart Failure, Cleveland, OH 44195, USA.
Starling
Randall C
RC
D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000276:immunology*; D015897:Comorbidity; D003324:Coronary Artery Disease; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D018450:Disease Progression; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D011494:Protein Kinases / Q000627:therapeutic use; D012307:Risk Factors; D058570:TOR Serine-Threonine Kinases; D014184:Transplantation, Homologous; D018084:Ultrasonography, Interventional
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011494:Protein Kinases; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases