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, B; Jansson, K; Eiskjaer, H; Bøtker, H E; Mortensen, S-A; Saunamaki, K; Gude, E; Ragnarsson, A; Solbu, D; Aukrust, P; Gullestad, L (2012). Virtual histology assessment of cardiac allograft vasculopathy following introduction of everolimus--results of a multicenter trial. American journal of transplantation, 12(10), pp. 2700-9. Oxford: Wiley-Blackwell 10.1111/j.1600-6143.2012.04234.x

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Sigurdardottir, Vilborg Thorunn

ISSN:

1600-6135

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:38

Last Modified:

17 Mar 2015 21:29

Publisher DOI:

10.1111/j.1600-6143.2012.04234.x

PubMed ID:

22958738

Web of Science ID:

000309180000017

URI:

https://boris.unibe.ch/id/eprint/15192 (FactScience: 222468)

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