Koronare Endotheldysfunktion und Graft-Atheromatose nach Herztransplantation. [Coronary endothelial dysfunction and graft atheromatosis following heart transplantation]

Details

Serval ID
serval:BIB_72A087449E1F
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Koronare Endotheldysfunktion und Graft-Atheromatose nach Herztransplantation. [Coronary endothelial dysfunction and graft atheromatosis following heart transplantation]
Journal
Schweizerische Medizinische Wochenschrift
Author(s)
Vassalli  G.
ISSN
0036-7672 (Print)
Publication state
Published
Issued date
10/1995
Volume
125
Number
41
Pages
1923-30
Notes
English Abstract
Journal Article
Review --- Old month value: Oct 14
Abstract
Graft atheromatosis is the most important limiting factor on long-term survival after heart transplantation. Histologically it involves so-called myointimal proliferation occurring in either circumscribed or diffuse form. Endothelial dysfunction with impaired release of nitric oxide represents an early stage of graft atheromatosis. Progression of the disease typically leads to a diffuse narrowing of the coronary tree; however, focal stenoses may also occur. Endothelial dysfunction results in a decrease in physiological coronary flow reserve during exercise, whereas pharmacological flow reserve after papaverine or adenosine administration is maintained. This functional disturbance can be enhanced by transplantation-related (e.g., vascular graft rejections, cytomegalovirus infections, etc.) as well as by cardiovascular risk factors (e.g., hypercholesterolemia, hypertension). The occurrence of endothelial dysfunction and graft atheromatosis may be delayed, although probably not prevented, by elimination of risk factors and optimization of immunosuppressive treatment. Preliminary data suggest that long-term administration of the calcium-antagonist diltiazem may have a protective effect.
Keywords
Coronary Arteriosclerosis/*physiopathology/prevention & control Coronary Circulation Cytomegalovirus Infections/physiopathology Diltiazem/therapeutic use Endothelium, Vascular/*physiopathology Graft Rejection/physiopathology *Heart Transplantation Humans Nitric Oxide/physiology Postoperative Complications/*etiology Risk Factors
Pubmed
Web of science
Create date
28/01/2008 10:32
Last modification date
20/08/2019 14:30
Usage data