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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)
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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
2016-04-04 08:36:03
date last changed
2022-05-01 06:40:49
@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}},
  doi          = {{10.1111/j.1600-6143.2012.04234.x}},
  volume       = {{12}},
  year         = {{2012}},
}