Can angiographically silent coronary atherosclerosis predict mortality after cardiac transplantation?
Ik-Kyung Jang
Correspondence Harvard Medical School, Massachusetts General Hospital, Bigelow 800, 55 Fruit Street, Boston, MA 02114 USA
Email ijang@partners.org
This article has no abstract so we have provided the first paragraph of the full text.
Coronary vasculopathy is the major cause of morbidity and mortality in post-heart-transplant patients. Since the typical presentation of advanced coronary artery disease in these patients is sudden death, heart failure or arrhythmia rather than exertional angina, these patients undergo annual coronary angiography. Due to the low resolution and intrinsic limitations of the luminogram, however, coronary angiography fails to detect the early development of atherosclerosis. By the time that coronary artery stenoses are detected on a coronary angiogram, the patient often has advanced coronary disease and therefore treatment options are limited. IVUS is an invasive imaging method, which is widely used during percutaneous coronary interventions and in the follow-up of patients after organ transplant. This technique provides valuable information on changes in the vessel wall such as intimal thickening and vascular remodeling1, 2 before the luminal narrowing becomes obvious on a coronary angiogram.
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