Cardiac transplantation has emerged as an effective treatment modality for patients with end stage heart disease.
According to the International Society for Heart and Lung Transplantation, it has been estimated that more than 5,000 heart transplants are performed every year worldwide(1).
The Heart and Stroke Statistics 2012 update by American Heart Association estimated that about 2333 cardiac transplantation procedures were performed in 2010 in the United States alone(2).
Cardiac allograft vasculopathy (CAV) is a unique and aggressive form of atherosclerosis affecting the coronary arteries of the allografts. Although significant advances in cardiac transplantation and post transplant care over the last three decades have led to substantial …show more content…
In addition, it has been shown to be associated with a mortality rate as high as 90% at the end of one year after diagnosis in patients with 3-vessel CAV(4).
Newer immunosuppressive agents have been found to prevent, delay progression and even lead to regression of CAV. This makes early identification of CAV important.
Early diagnosis is imperative as it can facilitate the essential alterations in the medication regimen before reaching a stage where revascularization will be the only alternative. Several lines of evidence point out the importance of early diagnosis as alterations in the immunosuppressive regimen can lead to delay in development and progression of CAV and even cause its regression.
Clinical diagnosis of CAV remains difficult as patients with CAV tend to remain asymptomatic till late and rarely present with symptoms of typical ischemia due to the lack of innervation in the allograft. They may present at a later stage when the graft is already compromised with symptoms of heart failure, ventricular arrhythmias and sudden cardiac …show more content…
With advances in its technology, it is being increasingly studied for its potential role as a noninvasive and cost effective modality in heart transplant recipients for early identification of CAV. Comparative effectiveness studies evaluating the diagnostic accuracy of the 64-section CTA with invasive angiography have shown promising results in identifying obstructive CAV however with a limitation of including a small number of patients(10,
According to the International Society for Heart and Lung Transplantation, it has been estimated that more than 5,000 heart transplants are performed every year worldwide(1).
The Heart and Stroke Statistics 2012 update by American Heart Association estimated that about 2333 cardiac transplantation procedures were performed in 2010 in the United States alone(2).
Cardiac allograft vasculopathy (CAV) is a unique and aggressive form of atherosclerosis affecting the coronary arteries of the allografts. Although significant advances in cardiac transplantation and post transplant care over the last three decades have led to substantial …show more content…
In addition, it has been shown to be associated with a mortality rate as high as 90% at the end of one year after diagnosis in patients with 3-vessel CAV(4).
Newer immunosuppressive agents have been found to prevent, delay progression and even lead to regression of CAV. This makes early identification of CAV important.
Early diagnosis is imperative as it can facilitate the essential alterations in the medication regimen before reaching a stage where revascularization will be the only alternative. Several lines of evidence point out the importance of early diagnosis as alterations in the immunosuppressive regimen can lead to delay in development and progression of CAV and even cause its regression.
Clinical diagnosis of CAV remains difficult as patients with CAV tend to remain asymptomatic till late and rarely present with symptoms of typical ischemia due to the lack of innervation in the allograft. They may present at a later stage when the graft is already compromised with symptoms of heart failure, ventricular arrhythmias and sudden cardiac …show more content…
With advances in its technology, it is being increasingly studied for its potential role as a noninvasive and cost effective modality in heart transplant recipients for early identification of CAV. Comparative effectiveness studies evaluating the diagnostic accuracy of the 64-section CTA with invasive angiography have shown promising results in identifying obstructive CAV however with a limitation of including a small number of patients(10,