Clinical implication of microvasculopathy in patients post heart transplantation
10.3760/cma.j.issn.0253-3758.2011.02.015
- VernacularTitle:心脏移植术后微血管病变的临床意义
- Author:
Li LI
1
;
Hong-Yue WANG
;
Lai-Feng SONG
;
Lin-Lin WANG
;
Yong GUO
;
Ran-Xu ZHAO
;
Wen-Xue SI
;
Qing-Zhi WANG
;
Jian ZHANG
;
Jie HUANG
;
Hong ZHAO
Author Information
1. 中国医学科学院北京协和医学院,阜外心血管病医院
- Keywords:
Heart transplantation;
Coronary stenosis;
Microvasculopathy
- From:
Chinese Journal of Cardiology
2011;39(2):156-159
- CountryChina
- Language:Chinese
-
Abstract:
Objective Assess the clinical implication of microvasculopathy detected by endomyocardial biopsy samples in patients post heart transplantation. Methods Light microscopic evaluations were performed in 278 endomyocardial biopsies harvested from 64 patients post heart transplantation for more than one year, microvasculopathy was defined as stenotic endothelial and/or medial disease. Results The patients with stenotic microvasculopathy were younger than those without microvasculopathy (40. 7 ± 15.9 vs . 49.4 ± 8.7, P ＜ 0. 05 ). The mean score of acute cellular rejection (0. 83 ±0. 39 vs. 0. 37 ±0. 32, P ＜0. 01 ) and the numbers of≥grade II acute rejection (0. 84 ±0. 16 vs.0. 23 ± 0. 10, P ＜ 0. 01 ) were significantly greater in stenotic microvasculopathy group compared to those of non-stenotic group. Multivariate regression analysis confirmed that stenotic microvasculopathy is the independent risk factor for the mean acute rejection score (OR = 3.40, 95% CI, 4.62- 193.07, P ＜0. 01 ), but not for the Quilty lesion, coronary heart disease of donor, diabetes mellitus. Angiographically confirmed coronary vasculopathy and cardiac dysfunction ( x2 = 0. 94, P ＞ 0. 05 and x2 = 2.90, P ＞ 0. 05 )were similar between microvasculopathy group and non-microvasculopathy group. Conclusion Post heart transplantation microvasculopathy is an immune-mediated phenomenon and associated with higher mean score of acute cellular rejection and higher numbers of ≥ grade Ⅱ acute rejection but was not the prognostic risk factor for coronary vasculopathy and function reduction after heart transplantation.
