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Allograft vasculopathy

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https://www.readbyqxmd.com/read/29466490/heart-transplantation-for-peripartum-cardiomyopathy-a-single-center-experience
#1
Nadia Bouabdallaoui, Pierre Demondion, Sylvestre Maréchaux, Shaida Varnous, Guillaume Lebreton, Frédéric Mouquet, Pascal Leprince
BACKGROUND: Peripartum cardiomyopathy is an idiopathic disorder defined by the occurrence of acute heart failure during late pregnancy or post-partum period in the absence of any other definable cause. Its clinical course is variable and severe cases might require heart transplantation. OBJECTIVE: To investigate long-term outcomes after heart transplantation (HT) for peripartum cardiomyopathy (PPCM). METHODS: Out of a single-center series of 1938 HT, 14 HT were performed for PPCM...
February 19, 2018: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29453887/coronary-artery-disease-in-heart-transplantation-new-concepts-for-an-old-disease
#2
REVIEW
Mandy Langstraat, Kyra J S Musters, Olivier Manintveld, Marco Masetti, Luciano Potena
BACKGROUND: Cardiac allograft vasculopathy (CAV) remains one of the main long-term complications after heart transplantation. We performed a systematic review focused on articles published in the previous 6 years to reappraise the novel evidences supporting risk-factors, pathology, prevention and treatment of CAV. METHODS: We identified a search string for a literature search on PubMed. We excluded articles specifically focused on diagnosis/biomarkers/imaging only or complications of other diseases...
February 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29420960/long-term-sirolimus-for-primary-immunosuppression-in-heart-transplant-recipients
#3
Rabea Asleh, Alexandros Briasoulis, Walter K Kremers, Rosalyn Adigun, Barry A Boilson, Naveen L Pereira, Brooks S Edwards, Alfredo L Clavell, John A Schirger, Richard J Rodeheffer, Robert P Frantz, Lyle D Joyce, Simon Maltais, John M Stulak, Richard C Daly, Jonella Tilford, Woong-Gil Choi, Amir Lerman, Sudhir S Kushwaha
BACKGROUND: Small studies have reported superiority of sirolimus (SRL) over calcineurin inhibitor (CNI) in mitigating cardiac allograft vasculopathy (CAV) after heart transplantation (HT). However, data on the long-term effect on CAV progression and clinical outcomes are lacking. OBJECTIVES: The aim of this study was to test the long-term safety and efficacy of conversion from CNI to SRL as maintenance therapy on CAV progression and outcomes after HT. METHODS: A cohort of 402 patients who underwent HT and were either treated with CNI alone (n = 134) or converted from CNI to SRL (n = 268) as primary immunosuppression was analyzed...
February 13, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29389808/cross-modality-accuracy-of-dual-step-prospectively-electrocardiography-triggered-dual-source-computed-tomorgaphy-compared-with-same-day-echocardiography-and-cardiac-magnetic-resonance-imaging-in-the-follow-up-of-heart-transplant-patients
#4
Riccardo Marano, Biagio Merlino, Luigi Natale, Giancarlo Savino, Vincenzo Vingiani, Giuseppe Rovere, Anna Rita Larici, Roberto Iezzi, Nicola Magarelli, Antonella Lombardo, Massimo Pasquale, Riccardo Manfredi
PURPOSE: An accurate evaluation of left ventricular volumes, mass, and ejection fraction (EF) and an early exclusion or detection of significant coronary artery disease or cardiac allograft vasculopathy are mandatory for clinical management and prognosis assessment of heart-transplanted patients (HTP). The purpose of this article was to evaluate the role of dual-step prospective electrocardiography-triggered Dual-Source CT (pECGdual-step-DSCT) in HTP for the assessment of left-ventricular function, in comparison with echocardiography (echo) and cardiac magnetic resonance (CMR) performed on the same day, and of the coronary arteries as well...
January 31, 2018: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/29378756/lymphangiogenesis-in-chronic-rejection-and-coronary-allograft-vasculopathy-an-emerging-diagnostic-and-therapeutic-target
#5
EDITORIAL
H Scott Baldwin, Stavros G Drakos
No abstract text is available yet for this article.
January 30, 2018: Circulation
https://www.readbyqxmd.com/read/29351613/the-beginning-at-the-end-non-invasive-assessment-of-post-transplant-coronary-allograft-vasculopathy-at-the-microcirculatory-level
#6
Ornella Rimoldi, Paolo G Camici
No abstract text is available yet for this article.
December 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29349819/incidence-and-predictors-of-sudden-cardiac-death-after-heart-transplantation-a-systematic-review-and-meta-analysis
#7
Ana C Alba, Farid Foroutan, Nicholas Kwet Vong Ng Fat Hing, Chun-Po S Fan, Cedric Manlhiot, Heather J Ross
PORPUSE: Sudden cardiac death (SCD) is an important post-transplant problem being responsible for approximately 10% of deaths. We conducted a systematic review and meta-analysis to evaluate incidence and predictors of post-heart transplant SCD, and use of implantable cardiac defibrillator (ICD). METHODS: Citations were identified in electronic databases and references of included studies. Observational studies on adults reporting on incidence and predictors of post-transplant SCD and ICD use were selected...
January 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29337706/cholesterol-efflux-in-the-transplant-patient
#8
Sangita Sudharshan, Ali Javaheri
PURPOSE OF REVIEW: Cholesterol metabolism is increasingly recognized in inflammatory diseases including transplantation. This review discusses the mechanistic underpinnings that tie macrophage cholesterol efflux capacity (CEC) of high-density lipoprotein (HDL) to chronic rejection in transplanted patients. RECENT FINDINGS: Animal studies suggest that administration of apolipoprotein A-I, the main protein constituent of HDL, can prevent transplant arteriosclerosis...
January 13, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29319621/selective-cd28-inhibition-modulates-alloimmunity-and-cardiac-allograft-vasculopathy-in-anti-cd154-treated-monkeys
#9
Tianshu Zhang, Agnes M Azimzadeh, Wenji Sun, Natalie A O'Neill, Evelyn Sievert, Emily Bergbower, Gheorghe Braileanu, Lars Burdorf, Xiangfei Cheng, Thomas Monahan, Siamak Dahi, Donald Harris, Elana Rybak, Emily Welty, Anthony Kronfli, Chris Avon, Richard N Pierson
BACKGROUND: Selective CD28 inhibition is actively pursued as an alternative to B7 blockade using CTLA4-Ig based on the hypothesis that the checkpoint immune regulators CTLA-4 and PD-L1 will induce tolerogenic immune signals. We previously showed that blocking CD28 using a monovalent nonactivating reagent (single chain anti-CD28 Fv fragment linked to alpha-1 anti-trypsin: sc28AT) synergizes with calcineurin inhibitors in nonhuman primate (NHP) kidney and heart transplantation. Here, we explored the efficacy of combining a 3-week 'induction" sc28AT treatment with prolonged CD154 blockade...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29315873/dominance-of-free-wall-radial-motion-in-global-right-ventricular-function-of-heart-transplant-recipients
#10
Bálint Károly Lakatos, Márton Tokodi, Alexandra Assabiny, Zoltán Tősér, Annamária Kosztin, Alexandra Doronina, Kristóf Rácz, Kinga Bianka Koritsánszky, Viktor Berzsenyi, Endre Németh, Balázs Sax, Attila Kovács, Béla Merkely
Assessment of right ventricular (RV) function using conventional echocardiography might be inadequate as the radial motion of the RV free wall is often neglected. Our aim was to quantify the longitudinal and the radial components of RV function using three-dimensional (3D) echocardiography in heart transplant (HTX) recipients. 51 HTX patients in stable cardiovascular condition without history of relevant rejection episode or chronic allograft vasculopathy and 30 healthy volunteers were enrolled. RV end-diastolic (EDV) volume and total ejection fraction (TEF) were measured by 3D echocardiography...
January 8, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29260577/coronary-computed-tomography-in-heart-transplant-patients-detection-of-significant-stenosis-and-cardiac-allograft-vasculopathy-image-quality-and-radiation-dose
#11
Anne Günther, Lars Aaberge, Andreas Abildgaard, Asgrimur Ragnarsson, Thor Edvardsen, Jarl Jakobsen, Rune Andersen
Background Cardiac allograft vasculopathy (CAV) is an accelerated form of atherosclerosis unique to heart transplant (HTX) patients. Purpose To investigate the detection of significant coronary artery stenosis and CAV, determinants of image quality, and the radiation dose in coronary computed tomography angiography (CCTA) of HTX patients with 64-slice multidetector CT (64-MDCT). Material and Methods Fifty-two HTX recipients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and underwent CCTA before ICA with intravascular ultrasound (IVUS)...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29236988/diagnostic-and-prognostic-value-of-myocardial-blood-flow-quantification-as-non-invasive-indicator-of-cardiac-allograft-vasculopathy
#12
Paco E Bravo, Brian A Bergmark, Tomas Vita, Viviany R Taqueti, Ankur Gupta, Sara Seidelmann, Thomas E Christensen, Michael T Osborne, Nishant R Shah, Nina Ghosh, Jon Hainer, Courtney F Bibbo, Meagan Harrington, Fred Costantino, Mandeep R Mehra, Sharmila Dorbala, Ron Blankstein, Akshay Desai, Lynne Stevenson, Michael M Givertz, Marcelo F Di Carli
Aims: Cardiac allograft vasculopathy (CAV) is a leading cause of death in orthotopic heart transplant (OHT) survivors. Effective non-invasive screening methods are needed. Our aim was to investigate the added diagnostic and prognostic value of myocardial blood flow (MBF) to standard myocardial perfusion imaging (MPI) with positron emission tomography (PET) for CAV detection. Methods and results: We studied 94 OHT recipients (prognostic cohort), including 66 who underwent invasive coronary angiography and PET within 1 year (diagnostic cohort)...
December 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29222866/outcome-of-antibody-mediated-rejection-compared-to-acute-cellular-rejection-after-pediatric-heart-transplantation
#13
Gabrielle R Vaughn, Neal W Jorgensen, Yuk M Law, Erin L Albers, Borah J Hong, Joshua M Friedland-Little, Mariska S Kemna
Outcomes of ACR after pediatric HTx have been well described, but less has been reported on outcomes of AMR. We compared the clinical characteristics and cardiovascular outcomes (composite end-point of death, retransplantation, or allograft vasculopathy) of pediatric HTx recipients with AMR, ACR, and no rejection in a retrospective single-center study of 104 recipients. Twenty were treated for AMR; 15 were treated for ACR. Recipients with AMR had an increased frequency of congenital heart disease (90% vs ACR 67% vs no rejection 59%, P = ...
February 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29222132/invasive-assessment-of-the-coronary-microvasculature-the-index-of-microcirculatory-resistance
#14
REVIEW
William F Fearon, Yuhei Kobayashi
Traditionally, invasive coronary physiological assessment has focused on the epicardial coronary artery. More recently, appreciation of the importance of the coronary microvasculature in determining patient outcomes has grown. Several invasive modalities for interrogating microvascular function have been proposed. Angiographic techniques have been limited by their qualitative and subjective nature. Doppler wire-derived coronary flow reserve has been applied in research studies, but its clinical role has been limited by its lack of reproducibility, its lack of a clear normal value, and the fact that it is not specific for the microvasculature but interrogates the entire coronary circulation...
December 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29194769/intravascular-ultrasound-of-the-proximal-left-anterior-descending-artery-is-sufficient-to-detect-early-cardiac-allograft-vasculopathy
#15
Vincent Floré, Adam J Brown, Stephen J Pettit, Nick E J West, Clive Lewis, Jayan Parameshwar, Stephen P Hoole
OBJECTIVE: Cardiac allograft vasculopathy (CAV) can be detected early with intravascular ultrasound (IVUS), but there is limited information on the most efficient imaging protocol. METHODS: Coronary angiography and IVUS of the three coronary arteries were performed. Volumetric IVUS analysis was performed, and a Stanford grade determined for each vessel. RESULTS: Eighteen patients were included 18 (range 12-24) months after transplantation...
February 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29191296/cardiac-allograft-vasculopathy-it-really-has-changed-over-time
#16
EDITORIAL
Sharon A Hunt
No abstract text is available yet for this article.
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29191295/changes-in-outcomes-of-cardiac-allograft%C3%A2-vasculopathy-over-30-years-following-heart-transplantation
#17
Maxime Tremblay-Gravel, Normand Racine, Simon de Denus, Anique Ducharme, Guy B Pelletier, Geneviève Giraldeau, Mark Liszkowski, Marie-Claude Parent, Michel Carrier, Annik Fortier, Michel White
OBJECTIVES: This study investigated temporal changes in the demographics and the prognosis of cardiac allograft vasculopathy (CAV) over 30 years following heart transplantation (HTx). BACKGROUND: Effects of the changing HTx demographics on CAV outcomes, based on International Society for Heart and Lung Transplantation (ISHLT) classification of CAV, have been incompletely investigated. METHODS: Patients who underwent HTx at the Montreal Heart Institute were classified according to the severity of CAV (CAV 0 is no presence of CAV; CAV 1 is mild, CAV 2 to 3 is moderate to severe) and era of HTx (early: 1983 to 1998; recent: 1999 to 2011)...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29191294/evolving-areas-in-heart-transplantation
#18
REVIEW
Brittany N Weber, Jon A Kobashigawa, Michael M Givertz
It has been 50 years since Dr. Christiaan Barnard performed the first human-to-human heart transplant in December 1967 in South Africa. Remarkable progress has been made since that time, including changes in surgical techniques, immunosuppression, donor and recipient selection, and post-transplant care. In this paper, we provide a perspective on the changing face of heart transplantation and highlight key evolving areas. Topics that are covered include advances in immunosuppression, screening for acute and chronic rejection, cardiac allograft vasculopathy, and ongoing advancements in cardiac replacement therapy, including xenotransplantation, stem-cell research, tissue engineering, and the total artificial heart...
December 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29173389/the-scourge-and-enigmatic-journey-of-cardiac-allograft-vasculopathy
#19
EDITORIAL
Mandeep R Mehra
No abstract text is available yet for this article.
December 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29146891/heart-transplantation-and-risk-of-cardiac-vasculopathy-development-what-factors-are-important
#20
Małgorzata Sobieszczańska-Małek, Jerzy Korewicki, Krzysztof Komuda, Małgorzata Karczmarz, Sylwia Szymańska, Alicja Cicha-Mikołajczyk, Paweł Bekta, Adam Parulski, Maciej Pronicki, Wiesława Grajkowska, Grzegorz Małek, Przemysław Leszek, Maria Kaczorowska, Mariusz Kuśmierczyk, Tomasz Zieliński
BACKGROUND The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL AND METHODS There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest)...
November 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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