Fatores de risco cardiovascular e doença vascular do enxerto em uma coorte de pacientes submetidos a transplante cardíaco

• Ano de defesa: 2019
• Autor(a) principal: Karla Cordeiro Gonçalves
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Doença da artéria coronária; Transplante de coração; Oclusão coronária; Doença vascular do enxerto; Fatores de risco cardiovascular; Doenças Vasculares; Transplante de Coração; Oclusão Coronária; Doença da Artéria Coronariana; Fatores de Risco
• Link de acesso: http://hdl.handle.net/1843/BUOS-BCDRXH

Introduction: Cardiac transplantation (CT) is the established treatment for severe and refractory heart failure (HF). Late complications, represent a serious problem that ends up limiting and determining the average life expectancy of the transplanted patient. Cardiac allograft vasculopathy (CAV) is the main cause of graft failure and death one year after cardiac transplantation. Objective: To verify the association between classic cardiovascular risk factors and CAV in patients submitted to heart transplantation. METHODS: This is an observational study with a predominantly longitudinal delineation, a historical cohort, in which classic cardiovascular markers were evaluated in 178 cardiac transplant patients and their relationship with CAV. The CAV was evaluated in 81 patients, those who had coronary angiography after one year of CT. In a cross-sectional study, the level of physical activity was evaluated using the IPAQ questionnaire, short version, in 135 live transplant patients. Associations between classical and non-classical risk factors with CAV were performed. Results: A sample of 178 patients was predominantly male (65.73%), with a median age of 46 (15-68), whose primary etiology HF prior CT was chagasic myocardiopathy (MCP) (42.45%). 79.2% of the patients developed hypertension after the CT, 26.97% diabetes, 14.02% obesity and 38.8% dyslipidemia 1% of pre-TC smokers returned to smoking after the procedure. Among the non-classic risk factors, there was a prevalence of metabolic syndrome (MS) (31.55%) and sedentary lifestyle (18.5%). 45.2% were physically active and 55.5% of the transplanted patients had excess body mass index (overweight and obesety). The incidence of CAV was 18.5%. The mean time to the occurrence of CAV after CT was 66 months (± 34,664), more prevalent in males (80%) and 40% of the identified cases were severe cases. The presence of CAV was not associated with classic cardiovascular risk factors and non-classical risk factors such as MS and sedentary lifestyle. Conclusion: In this study, an increase in the occurrence of classic cardiovascular risk factors was observed in the cohort of patients submitted to CT in relation to the pre-CT period and an important occurrence of MS and sedentary lifestyle, but there wasnt association between CAV and classic and non-classic risk factors cardiovascular