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Microcirculatory Re...
Microcirculatory Resistance Predicts Allograft Rejection and Cardiac Events After Heart Transplantation
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Ahn, J. M. (författare)
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Zimmermann, F. M. (författare)
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Gullestad, L. (författare)
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- Angerås, Oskar, 1976 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Karason, Kristjan, 1962 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Russell, K. (författare)
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Lunde, K. (författare)
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Okada, K. (författare)
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Luikart, H. (författare)
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Khush, K. K. (författare)
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Honda, Y. (författare)
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Pijls, N. H. J. (författare)
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Lee, S. E. (författare)
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Kim, J. J. (författare)
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Park, S. J. (författare)
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Solberg, O. G. (författare)
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Fearon, W. F. (författare)
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(creator_code:org_t)
- Elsevier BV, 2021
- 2021
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097. ; 78:24, s. 2425-2435
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Single-center data suggest that the index of microcirculatory resistance (IMR) measured early after heart transplantation predicts subsequent acute rejection. OBJECTIVES: The goal of this study was to validate whether IMR measured early after transplantation can predict subsequent acute rejection and long-term outcome in a large multicenter cohort. METHODS: From 5 international cohorts, 237 patients who underwent IMR measurement early after transplantation were enrolled. The primary outcome was acute allograft rejection (AAR) within 1 year after transplantation. A key secondary outcome was major adverse cardiac events (MACE) (the composite of death, re-transplantation, myocardial infarction, stroke, graft dysfunction, and readmission) at 10 years. RESULTS: IMR was measured at a median of 7 weeks (interquartile range: 3-10 weeks) post-transplantation. At 1 year, the incidence of AAR was 14.4%. IMR was associated proportionally with the risk of AAR (per increase of 1-U IMR; adjusted hazard ratio [aHR]: 1.04; 95% confidence interval [CI]: 1.02-1.06; p < 0.001). The incidence of AAR in patients with an IMR >= 18 was 23.8%, whereas the incidence of AAR in those with an IMR <18 was 6.3% (aHR: 3.93; 95% CI: 1.77-8.73; P = 0.001). At 10 years, MACE occurred in 86 (36.3%) patients. IMR was significantly associated with the risk of MACE (per increase of 1-U IMR; aHR: 1.02; 95% CI: 1.01-1.04; P = 0.005). CONCLUSIONS: IMR measured early after heart transplantation is associated with subsequent AAR at 1 year and clinical events at 10 years. Early IMR measurement after transplantation identifies patients at higher risk and may guide personalized posttransplantation management. Published by Elsevier on behalf of the American College of Cardiology Foundation.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- heart transplantation
- index of microcirculatory resistance
- microvascular dysfunction
- personalized management
- prognosis
- rejection
- acute cellular rejection
- risk-factors
- subsequent development
- international society
- working formulation
- invasive assessment
- flow
- reserve
- coronary
- index
- standardization
- Cardiovascular System & Cardiology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Ahn, J. M.
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Zimmermann, F. M ...
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Gullestad, L.
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Angerås, Oskar, ...
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Karason, Kristja ...
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Russell, K.
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visa fler...
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Lunde, K.
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Okada, K.
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Luikart, H.
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Khush, K. K.
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Honda, Y.
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Pijls, N. H. J.
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Lee, S. E.
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Kim, J. J.
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Park, S. J.
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Solberg, O. G.
-
Fearon, W. F.
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visa färre...
- Om ämnet
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och Klinisk medicin
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och Kardiologi
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Göteborgs universitet