PUBLICAÇÕES científicas

Microvascular coronary arterial vasculopathy--predictive value of endomyocardial biopsy

Lozano MD. [ES]
Department of Pathology, Clínica Universitaria, University of Navarra, 31080 Pamplona, Spain

Revisão:Zeitschrift fur Kardiologie

Data: 1/Jun/2000

Anatomia Patológica [ES]

Graft arteriosclerosis (GA) is characterized as a diffuse, usually concentric, proliferative lesion of uncertain pathogenesis that occurs in the coronary arteries of cardiac allografts involving both the microvasculature and epicardial vessels, and represents the major limitation to long-term recipient survival.

The whole length of the vessel is affected, including small distal intramyocardial branches, which precludes optimal treatment with routine revascularization procedures. The prevalence of GA at 5 years after transplantation is high. Early diagnosis of GA is limited by the lack of clinical symptoms for ischemia in the denervated allogaft, by the insensitivity of coronary angiography, which frequently underestimates the extent and severity of the disease, and by the exclusive or predominant involvement of small intramyocardial vessels in some cases.

The introduction of intracoronary ultrasound imaging supports earlier pathological data indicating that coronary angiography underestimates the severity of the disease. The use of intracoronary ultrasound has improved the early diagnosis of large vessel disease, but it lacks accessibility to distal lesions; thus, the extent of intramyocardial small artery disease remains relatively unexplored. Although it has been proposed that EMB could provide useful information on the diagnosis and development of allograft vasculopathy, less attention has been focused on the small intramyocardial vessels, as they appear in the endomyocardial biopsy (EMB), nor on the significance of the myocardial pathology resulting from the perfusion defects caused by GA.

The aim of this paper is to briefly review some of the pathogenic mechanisms responsible for the development of GA, and the pathological findings observed in the microvasculature of the myocardium with special attention to the lesions that can be noticed in EMBs.

CITAÇÃO DO ARTIGO  Z Kardiol. 2000;89 Suppl 9:IX/54-7

talvezlhe interesse

QUE TECNOLOGIA UTILIZAMOS? 

A Clínica é o hospital privado com maiores recursos tecnológicos de Espanha, tudo num único centro.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra

OS NOSSOS
PROFISSIONAIS

Os profissionais da Clínica realizam um trabalho contínuo de investigação e formação, sempre em benefício do paciente.

Imagen profesionales de la Clínica Universidad de Navarra

RAZÕES PARA VIR
À CLÍNICA

Conheça porque é que somos diferentes em relação a outros centros sanitários. Qualidade, rapidez, comodidade e resultados.

Imagen del edificio de la Clínica Universidad de Navarra