Cardiac allograft vasculopathy history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]; Raviteja Guddeti, M.B.B.S. [3]
Overview
Patients with cardiac allograft vasculopathy (CAV) do not present with typical angina symptoms due to cardiac denervation at the time of heart transplantation. CAV is responsible for approximately 40% of deaths in heart transplant recipients. Survival in these patients has improved significantly over the decades, owing primarily to improved diagnostic techniques, and optimal immunosuppression and risk factor modification. The 2013 adult heart transplant registry noted that 5-year survival in both pediatric and adult heart transplant recipients is 69%.
History and Symptoms
CAV may manifest as:
- Graft failure
- Arrhythmias
- Silent myocardial infarction: Due to denervation at the time of surgery patients with CAV rarely present with typical angina symptoms, especially in the initial years of transplantation.[1] However, studies have demonstrated that re-innervation does occur late after heart transplantation.[2]
- Sudden death
References
- ↑ Di Cori A, Petronio AS, Gemignani C, Zucchelli G, Di Bello V, Mariani M (2005). "Symptomatic acute myocardial infarction in a cardiac transplant recipient successfully treated with primary coronary angioplasty: evidence of prognostic importance of chest pain after cardiac transplantation". J Heart Lung Transplant. 24 (8): 1146–9. doi:10.1016/j.healun.2004.07.003. PMID 16102462.
- ↑ Gallego-Page JC, Segovia J, Alonso-Pulpón L, Alonso-Rodríguez M, Salas C, Ortíz-Berrocal J (2004). "Re-innervation after heart transplantation: a multidisciplinary study". J Heart Lung Transplant. 23 (6): 674–82. PMID 15366426.