vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2024-1-97-102vtio-1717Research ArticleТрансплантация сердца и вспомогательное кровообращениеHeart Transplantation and Assisted CirculationВозможности внутрисосудистых методов визуализации в диагностике васкулопатии трансплантированного сердца. Обзор литературыCapabilities of intravascular imaging techniques in the diagnosis of cardiac allograft vasculopathy: Literature reviewКолесниковА. Ю.KolesnikovA. Yu.

650002, Кемерово, Сосновый бульвар, 6.

 6, Sosnovy Bulvar, Kemerovo, 650002

inobi05@yandex.ruАрнтА. А.ArntA. A.

650002, Кемерово, Сосновый бульвар, 6.

 6, Sosnovy Bulvar, Kemerovo, 650002

КочергинН. А.KocherginN. A.

650002, Кемерово, Сосновый бульвар, 6.

 6, Sosnovy Bulvar, Kemerovo, 650002

ФГБНУ «Научный исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»РоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation20241812202326197102Copyright © Колесников А.Ю., Арнт А.А., Кочергин Н.А., 20242024Колесников А.Ю., Арнт А.А., Кочергин Н.А.Kolesnikov A.Y., Arnt A.A., Kochergin N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1717

Васкулопатия трансплантированного сердца (ВТС) – это форма ишемической болезни сердца, возникающая у пациентов после ортотопической трансплантации сердца. ВТС является одной из ведущих причин смерти реципиентов. Вероятность летального исхода составляет 10%. ВТС может манифестировать уже через 1 год после ортотопической трансплантации сердца. У больных отсутствует типичный для ишемической болезни сердца болевой синдром из-за денервации сердца. Первыми клиническими проявлениями могут быть застойная сердечная недостаточность, желудочковые аритмии или даже внезапная сердечная смерть. Наиболее частым методом диагностики ВТС является коронарография. Чувствительность ангиографии достаточно низкая (около 44%), что не позволяет выявлять ВТС на ранней стадии заболевания. Сегодня широкое распространение получили внутрисосудистые методы визуализации (внутрисосудистый ультразвук, оптическая когерентная томография), которые позволяют оценить морфологию поражения коронарных артерий, в том числе ВТС. Данная статья посвящена современным возможностям внутрисосудистых методов визуализации в диагностике ВТС. ВТС является основной причиной развития инфаркта миокарда и хронической сердечной недостаточности у пациентов после ОТС. Внутрисосудистые методы визуализации позволяют на ранних сроках диагностировать данную патологию и профилактировать неблагоприятный исход у сложной категории больных с трансплантированным сердцем. Учитывая преимущества оптической когерентной томографии и недостатки внутрисосудистого ультразвукового исследования, оптическая когерентная томография представляется более информативным методом диагностики ВТС.

Cardiac allograft vasculopathy (CAV) is a coronary heart disease (CHD), arising after an orthotopic heart transplant (OHT), and it is one of the leading causes of death in heart recipients. The probability of death is 10%. CAV can manifest as early as 1 year after OHT. Patients do not have pain syndrome that is typical for CHD due to cardiac denervation. The first clinical manifestations may be congestive heart failure, ventricular arrhythmias or even sudden cardiac death. Coronary angiography is the routine technique for CAV detection. However, it is not sensitive enough (about 44%) for CAV detection at an early stage of the disease. Today, intravascular imaging methods (intravascular ultrasound, optical coherence tomography), which allow the evaluation of the morphology of coronary artery lesions, including CAV, have become widespread. This article is devoted to the modern capabilities of intravascular imaging methods in the diagnosis of CAV. CAV is the main cause of myocardial infarction and chronic heart failure in patients after OHT. Intravascular imaging techniques allow early detection of this condition and prevention of unfavorable outcomes in a complex category of heart recipients. Given the advantages of optical coherence tomography (OCT) and disadvantages of intravascular ultrasound (IVUS), OCT appears to be a more informative method of CAV detection.

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The authors declare that there are no conflicts of interest present.