Early endothelial dysfunction predicts the development of transplant coronary artery disease at 1 year posttransplant
Early endothelial dysfunction predicts the development of transplant coronary artery disease at 1 year posttransplant
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DOI：
10.1161/01.cir.93.3.457
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发表时间：
1996-02-01
期刊：
影响因子：
37.8
通讯作者：
Anderson, TJ
中科院分区：
文献类型：
--
作者：
Davis, SF;Yeung, AC;Anderson, TJ
背景加速冠状动脉硬化是心脏移植后长期生存的主要障碍。内皮功能障碍在移植后早期很常见。尚未对同一患者的早期内皮功能障碍与同种异体移植动脉硬化的发展之间的关系进行连续分析。我们假设对乙酰胆碱的早期收缩反应表明内皮功能障碍，可以预测移植冠状动脉硬化的发展。方法和结果通过连续冠状动脉内乙酰胆碱输注对 20 名患者移植后早期内皮依赖性血管舒缩进行评估，并通过定量血管造影测量直径变化百分比。通过对同样 20 名患者使用血管内超声，量化初始研究和 1 年随访研究之间 46 个匹配冠状动脉节段的内膜指数 (Delta Ii) 和最大内膜厚度 [Delta Mt] 的变化，研究动脉硬化的发展。与具有正常内皮功能的冠状动脉节段（n=23）相比，具有内皮功能障碍的冠状动脉节段（收缩大于或等于 5%；n=23）在移植后 1 年表现出平均 Ii 和 Mt 显着增加（Delta Ii=7+/-2% 与 2+/-1% [P
Background Accelerated coronary arteriosclerosis is the major obstacle to long-term survival after cardiac transplantation. Endothelial dysfunction is common early posttransplant. The relationship between early endothelial dysfunction and the development of allograft arteriosclerosis has not been analyzed serially with intravascular ultrasound in the same patients. We hypothesized that an early constrictor response to acetylcholine, indicative of endothelial dysfunction, may predict the development of transplant coronary arteriosclerosis.Methods and Results Endothelium-dependent vasomotion was assessed early posttransplant in 20 patients by serial intracoronary acetylcholine infusion, and the percent change in diameter was measured by quantitative angiography. The development of arteriosclerosis was studied by use of intravascular ultrasound in the same 20 patients by quantifying the changes in intimal index (Delta Ii) and maximal intimal thickness [Delta Mt] of 46 matched coronary segments between initial and 1-year follow-up studies. Coronary segments with endothelial dysfunction (constriction greater than or equal to 5%; n=23) demonstrated a significantly greater increase in mean Ii and Mt by 1 year posttransplant compared with segments with normal endothelial function (n=23) (Delta Ii=7+/-2% versus 2+/-1% [P