CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY

Aim of the study is to show the pathogenetic importance of myocardial revascularization and to estimate quantitatively effi ciency of the treatment of cardiac allograft vasculopathy after heart transplantation.Materials and methods. 30 percutaneous coronary interventions (PCI) were performed to reci...

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Main Authors: B. L. Mironkov, V. V. Chestukhin, I. Yu. Tyunyaeva, I. G. Ryadovoy, E. N. Ostroumov, A. O. Shevchenko, A. B. Mironkov, A. Ya. Kormer
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2014-12-01
Series:Вестник трансплантологии и искусственных органов
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Online Access:https://journal.transpl.ru/vtio/article/view/465
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author B. L. Mironkov
V. V. Chestukhin
I. Yu. Tyunyaeva
I. G. Ryadovoy
E. N. Ostroumov
A. O. Shevchenko
A. B. Mironkov
A. Ya. Kormer
author_facet B. L. Mironkov
V. V. Chestukhin
I. Yu. Tyunyaeva
I. G. Ryadovoy
E. N. Ostroumov
A. O. Shevchenko
A. B. Mironkov
A. Ya. Kormer
author_sort B. L. Mironkov
collection DOAJ
description Aim of the study is to show the pathogenetic importance of myocardial revascularization and to estimate quantitatively effi ciency of the treatment of cardiac allograft vasculopathy after heart transplantation.Materials and methods. 30 percutaneous coronary interventions (PCI) were performed to recipients of heart transplant (8 men and 7 women, aged from 18 to 56 years), who were diagnosed with cardiac allograft vasculopathy by coronary angiography within the time period from 1,5 to 12 years after heart transplantation. Before revascularization and one week after tolerances to physical activity, volume characteristics of the left ventricle were defi ned and diastolic function of heart was estimated. Average term of observation after stenting was 35,5 ± 5,5 months.Results. Tolerance to physical activity (from 76,6 ± 8,5 to 116,9 ± 9,6 W), its duration (from 5,4 ± 2,2 to 8,5 ± 4,1 min) and rate pressure product – RPP (from 198 ± 15 to 247 ± 24 P < 0,05) increased. There was a restoration of diastolic function (Ve/Va from 0,57 ± 0,18 to 1,15 ± 0,2 P < 0,05). Signifi cant distinction in time frames of vasculopathy development, frequency and reasons of repeated interventions depending on age of patients is revealed. In the group of patients younger than 30 years of age (7 patients), the time interval between heart transplantation and vasculopathy development is twice shorter, than in more senior patient group, over 45 years old (8 patients). Young patients showed the expressed tendency to develop stent restenosis (20 coronary interventions).Conclusion. Dynamics in functional condition of the left ventricle as a result of revascularization confi rms the leading role of miocardial ischemia in pathogenesis of transplant insuffi ciency due to vasculopathy. The signifi cant factor infl uencing upon long-term result of coronary intervention is the age of the patient.
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spelling doaj-art-8cb08055346440e38406587e4e17d7a52025-08-20T03:01:38ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912014-12-0116451010.15825/1995-1191-2014-4-5-10403CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHYB. L. Mironkov0V. V. Chestukhin1I. Yu. Tyunyaeva2I. G. Ryadovoy3E. N. Ostroumov4A. O. Shevchenko5A. B. Mironkov6A. Ya. Kormer7V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation N.I. Pirogov Russian National Research Medical University, Moscow, Russian FederationN.I. Pirogov Russian National Research Medical University, Moscow, Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationAim of the study is to show the pathogenetic importance of myocardial revascularization and to estimate quantitatively effi ciency of the treatment of cardiac allograft vasculopathy after heart transplantation.Materials and methods. 30 percutaneous coronary interventions (PCI) were performed to recipients of heart transplant (8 men and 7 women, aged from 18 to 56 years), who were diagnosed with cardiac allograft vasculopathy by coronary angiography within the time period from 1,5 to 12 years after heart transplantation. Before revascularization and one week after tolerances to physical activity, volume characteristics of the left ventricle were defi ned and diastolic function of heart was estimated. Average term of observation after stenting was 35,5 ± 5,5 months.Results. Tolerance to physical activity (from 76,6 ± 8,5 to 116,9 ± 9,6 W), its duration (from 5,4 ± 2,2 to 8,5 ± 4,1 min) and rate pressure product – RPP (from 198 ± 15 to 247 ± 24 P < 0,05) increased. There was a restoration of diastolic function (Ve/Va from 0,57 ± 0,18 to 1,15 ± 0,2 P < 0,05). Signifi cant distinction in time frames of vasculopathy development, frequency and reasons of repeated interventions depending on age of patients is revealed. In the group of patients younger than 30 years of age (7 patients), the time interval between heart transplantation and vasculopathy development is twice shorter, than in more senior patient group, over 45 years old (8 patients). Young patients showed the expressed tendency to develop stent restenosis (20 coronary interventions).Conclusion. Dynamics in functional condition of the left ventricle as a result of revascularization confi rms the leading role of miocardial ischemia in pathogenesis of transplant insuffi ciency due to vasculopathy. The signifi cant factor infl uencing upon long-term result of coronary intervention is the age of the patient.https://journal.transpl.ru/vtio/article/view/465cardiac allograft vasculopathycoronary interventionstent restenosis
spellingShingle B. L. Mironkov
V. V. Chestukhin
I. Yu. Tyunyaeva
I. G. Ryadovoy
E. N. Ostroumov
A. O. Shevchenko
A. B. Mironkov
A. Ya. Kormer
CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
Вестник трансплантологии и искусственных органов
cardiac allograft vasculopathy
coronary intervention
stent restenosis
title CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
title_full CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
title_fullStr CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
title_full_unstemmed CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
title_short CLINIC EFFICIENCY OF MYOCARDIAL REVASCULARIZATION FOR CARDIAC ALLOGRAFT VASCULOPATHY
title_sort clinic efficiency of myocardial revascularization for cardiac allograft vasculopathy
topic cardiac allograft vasculopathy
coronary intervention
stent restenosis
url https://journal.transpl.ru/vtio/article/view/465
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