Morphologic Features of the Recipient Heart in Patients Having Cardiac Transplantation and Analysis of the Congruence or Incongruence Between the Clinical and Morphologic Diagnoses
Morphologic Features of the Recipient Heart in Patients Having Cardiac Transplantation and Analysis of the Congruence or Incongruence Between the Clinical and Morphologic Diagnoses
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DOI：
10.1097/md.0000000000000038
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发表时间：
2014-07-01
期刊：
影响因子：
1.6
通讯作者：
Hall, Shelley Anne
中科院分区：
文献类型：
--
作者：
Roberts, William C.;Roberts, Carey Camille;Hall, Shelley Anne
心脏移植（CT）是近50年来最伟大的医学进步之一。我们研究了1993年至2012年在贝勒大学医学中心达拉斯接受CT检查的314例患者的心脏，并将CT前的形态学诊断与临床诊断进行了比较。在314例患者中，272例（87%）的形态学诊断与临床诊断一致，42例（13%）不一致。大多数不协调发生在166例非缺血性心肌病（non-IC）患者中（36/166 [22%]），其中主要的不协调发生在肥厚型心肌病患者中（7/17 [41%]），左室心肌致密化不全（NCLVC）（3/3 [100%]）、单核性心肌炎（3/3 [100%]）、致炎性右心室心肌病（ARVC）（4/4 [100%]）和心脏结节病（8/8 [100%]）。短语“非IC”是一个通用术语，包括心脏疾病的几个子集，简单地说是“1个或多个心外膜冠状动脉的不显著狭窄”，但它没有指定导致CT的心力衰竭的具体原因。提供了大量的心脏插图来证明IC和非IC患者之间发生的形态学变异性。
Cardiac transplantation (CT) has been one of the great medical advances of the last nearly 50 years. We studied the explanted hearts of 314 patients having CT at Baylor University Medical Center Dallas from 1993 to 2012, and compared the morphologic diagnoses to the clinical diagnoses before CT. Among the 314 patients the morphologic and clinical diagnoses were congruent in 272 (87%) and incongruent in 42 (13%). Most of the incongruity occurred among the 166 patients with non-ischemic cardiomyopathy (non-IC) (36/166 [22%]), and of that group the major incongruity occurred among the patients with hypertrophic cardiomyopathy (7/17 [41%]), non-compaction left ventricular cardiomyopathy (NCLVC) (3/3 [100%]), mononuclear myocarditis (3/3 [100%]), arrhythmogenic right ventricular cardiomyopathy (ARVC) (4/4 [100%]), and cardiac sarcoidosis (8/8 [100%]). The phrase "non-IC" is a general term that includes several subsets of cardiac diseases and simply means "insignificant narrowing of 1 or more of the epicardial coronary arteries," but it does not specify the specific cause of the heart failure leading to CT. A number of cardiac illustrations are provided to demonstrate the morphologic variability occurring among the patients with IC and non-IC.