Advanced

Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial.

Arora, S; Erikstad, I; Ueland, T; Sigurdardottir, V; Ekmehag, Björn LU ; Jansson, Kristina LU ; Eiskjaer, H; Bøtker, H E; Mortensen, S-A and Saunamaki, K, et al. (2012) In American Journal of Transplantation 12(10). p.2700-2709
Abstract
In this 12-month multicenter Scandinavian study, 78 maintenance heart transplant (HTx) recipients randomized to everolimus with reduced calcineurin inhibitor (CNI) exposure or continued standard CNI-therapy underwent matched virtual histology (VH) examination to evaluate morphological progression of cardiac allograft vasculopathy (CAV). Parallel measurement of a range of inflammatory markers was also performed. A similar rate of quantitative CAV progression was observed in the everolimus (n = 30) and standard CNI group (n = 48) (plaque index 1.9 ± 3.8% and 1.6 ± 3.9%, respectively; p = 0.65). However, VH analysis revealed a significant increase in calcified (2.4 ± 4.0 vs. 0.3 ± 3.1%; p = 0.02) and necrotic component (6.5 ± 8.5 vs. 1.1 ±... (More)
In this 12-month multicenter Scandinavian study, 78 maintenance heart transplant (HTx) recipients randomized to everolimus with reduced calcineurin inhibitor (CNI) exposure or continued standard CNI-therapy underwent matched virtual histology (VH) examination to evaluate morphological progression of cardiac allograft vasculopathy (CAV). Parallel measurement of a range of inflammatory markers was also performed. A similar rate of quantitative CAV progression was observed in the everolimus (n = 30) and standard CNI group (n = 48) (plaque index 1.9 ± 3.8% and 1.6 ± 3.9%, respectively; p = 0.65). However, VH analysis revealed a significant increase in calcified (2.4 ± 4.0 vs. 0.3 ± 3.1%; p = 0.02) and necrotic component (6.5 ± 8.5 vs. 1.1 ± 8.6%; p = 0.01) among everolimus patients compared to controls. The increase in necrotic and calcified components was most prominent in everolimus patients with time since HTx >5.1 years and was accompanied by a significant increase in levels of von Willebrand (vWF) factor (p = 0.04) and vascular cell adhesion molecule (VCAM) (p = 0.03). Conversion to everolimus and reduced CNI is associated with a significant increase in calcified and necrotic intimal components and is more prominent in patients with a longer time since HTx. A significant increase in vWF and VCAM accompanied these qualitative changes and the prognostic implication of these findings requires further investigation. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Transplantation
volume
12
issue
10
pages
2700 - 2709
publisher
Wiley-Blackwell
external identifiers
  • wos:000309180000017
  • pmid:22958738
  • scopus:84867057600
ISSN
1600-6135
DOI
10.1111/j.1600-6143.2012.04234.x
language
English
LU publication?
yes
id
8e70098e-b403-43bb-a9e4-5d7d9b3d19cb (old id 3124141)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22958738?dopt=Abstract
date added to LUP
2012-10-04 16:52:46
date last changed
2017-01-01 07:37:37
@article{8e70098e-b403-43bb-a9e4-5d7d9b3d19cb,
  abstract     = {In this 12-month multicenter Scandinavian study, 78 maintenance heart transplant (HTx) recipients randomized to everolimus with reduced calcineurin inhibitor (CNI) exposure or continued standard CNI-therapy underwent matched virtual histology (VH) examination to evaluate morphological progression of cardiac allograft vasculopathy (CAV). Parallel measurement of a range of inflammatory markers was also performed. A similar rate of quantitative CAV progression was observed in the everolimus (n = 30) and standard CNI group (n = 48) (plaque index 1.9 ± 3.8% and 1.6 ± 3.9%, respectively; p = 0.65). However, VH analysis revealed a significant increase in calcified (2.4 ± 4.0 vs. 0.3 ± 3.1%; p = 0.02) and necrotic component (6.5 ± 8.5 vs. 1.1 ± 8.6%; p = 0.01) among everolimus patients compared to controls. The increase in necrotic and calcified components was most prominent in everolimus patients with time since HTx >5.1 years and was accompanied by a significant increase in levels of von Willebrand (vWF) factor (p = 0.04) and vascular cell adhesion molecule (VCAM) (p = 0.03). Conversion to everolimus and reduced CNI is associated with a significant increase in calcified and necrotic intimal components and is more prominent in patients with a longer time since HTx. A significant increase in vWF and VCAM accompanied these qualitative changes and the prognostic implication of these findings requires further investigation.},
  author       = {Arora, S and Erikstad, I and Ueland, T and Sigurdardottir, V and Ekmehag, Björn and Jansson, Kristina and Eiskjaer, H and Bøtker, H E and Mortensen, S-A and Saunamaki, K and Gude, E and Ragnarsson, A and Solbu, D and Aukrust, P and Gullestad, L},
  issn         = {1600-6135},
  language     = {eng},
  number       = {10},
  pages        = {2700--2709},
  publisher    = {Wiley-Blackwell},
  series       = {American Journal of Transplantation},
  title        = {Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial.},
  url          = {http://dx.doi.org/10.1111/j.1600-6143.2012.04234.x},
  volume       = {12},
  year         = {2012},
}