See Article by Konerman et al Over the last 5 decades, significant advances in the care of heart transplant recipients have improved long-term survival. However, cardiac allograft vasculopathy (CAV) remains a significant problem with incidence varying from 30% at 5 years to 50% at 10 years. CAV is one of the leading causes of death after heart transplantation and accounts for ≈12% of deaths starting at 1 to 3 years posttransplant.1 CAV affects both epicardial and microvascular coronary vasculature. The microvascular dysfunction associated with CAV can result in early endothelial vasoreactive abnormalities which can reduce myocardial flow reserve (MFR). The pathogenesis of CAV is multifactorial and is influenced by both alloimmune dependent and independent factors.2 Because of denervation of the transplanted heart and absence of typical anginal symptoms, surveillance coronary angiography is recommended for CAV surveillance. Periodic screening is important for prognosis and management (ie, adjustment of cardiovascular and immunosuppressive therapies).3 Coronary angiography may not identify early small vessel or advanced diffuse CAV.4 Intravascular ultrasonography (IVUS) is more sensitive than angiography for CAV detection and has prognostic value with >0.5 mm intimal thickening in the first year posttransplant associated with increased risk of death and angiographic CAV development.5 Although considered the gold standard, IVUS has limitations. It is only able to image larger epicardial vessels and is better at identifying focal eccentric narrowing of the vessel lumen rather than the more diffuse pattern typically found in CAV. Invasive methods, in general, have significant limitations associated with procedural- and contrast-related complications as well as reduced …

中文翻译：

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用心脏正电子发射断层扫描术预测心脏同种异体移植血管病的未来

参见Konerman等人的文章在过去的5年中，心脏移植接受者护理方面的重大进步改善了长期存活率。然而，心脏同种异体移植血管病（CAV）仍然是一个重大问题，其发病率从5年的30％到10年的50％不等。CAV是心脏移植后死亡的主要原因之一，约占移植后1至3年死亡的12％。1CAV影响心外膜和微血管冠状动脉系统。与CAV相关的微血管功能障碍可导致早期内皮血管反应异常，从而减少心肌血流储备（MFR）。CAV的发病机制是多因素的，并且受同种免疫依赖和独立因素的影响。2由于移植心脏的神经支配并且没有典型的心绞痛症状，建议对冠状动脉造影进行冠状动脉造影检查。定期筛查对于预后和治疗（例如，调整心血管和免疫抑制疗法）很重要。3冠状动脉造影可能无法识别早期的小血管或晚期弥漫性CAV。4血管内超声检查（IVUS）比血管造影对CAV检测更为敏感，并且具有预后移植后第一年内膜增厚> 0.5 mm与死亡和血管造影CAV发展的风险增加相关。5尽管被认为是金标准，但IVUS有局限性。它仅能对较大的心外膜血管成像，并且比通常在CAV中发现的弥散性模式更好，因此可以更好地识别血管腔的局灶性偏心变窄。通常，侵入性方法具有与程序和对比相关的并发症相关的显着局限性，并且减少了…