Cardiac allograft vasculopathy (CAV) is a challenging complication of heart transplantation. CAV pathophysiology is incompletely understood, standard screening modalities such as angiography have significant limitations, and currently available therapies have only modest efficacy in preventing progression. Optical coherence tomography is a light-based technique that provides microscopic level catheter-based intravascular imaging and has dramatically expanded our understanding of CAV, demonstrating it to be a complex, heterogeneous, and dynamic process. This review covers characteristics and uses of optical coherence tomography, including vessel characterization, serial use to assess progression of disease, guiding percutaneous intervention, and monitoring response to CAV therapies. We also discuss the potential of optical coherence tomography in providing individualized assessment and enable customized CAV therapies, which may lead to improvements in long-term transplant outcomes.

中文翻译：

---

心脏同种异体血管病变的光学相干断层扫描

心脏同种异体移植血管病变 (CAV) 是心脏移植的一种具有挑战性的并发症。CAV 的病理生理学尚不完全清楚，血管造影等标准筛查方式有很大的局限性，目前可用的疗法在预防进展方面仅具有适度的功效。光学相干断层扫描是一种基于光的技术，可提供基于导管的微观水平血管内成像，极大地扩展了我们对 CAV 的理解，证明它是一个复杂、异质和动态的过程。本综述涵盖了光学相干断层扫描的特征和用途，包括血管特征、连续使用以评估疾病进展、指导经皮干预和监测对 CAV 治疗的反应。