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Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus—Results of a Multicenter Trial
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- Arora, Satish (author)
- Oslo University Hospital Rikshospitalet, Norway,Rigshospitalet, Copenhagen, Denmark
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- Erikstad, I. (author)
- Oslo University Hospital Rikshospitalet, Norway
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- Ueland, T. (author)
- Oslo University Hospital Rikshospitalet, Norway
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- Aukrust, P (author)
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- (creator_code:org_t)
- Wiley-Blackwell, 2012
- 2012
- English.
- In: American Journal of Transplantation. - : Wiley-Blackwell. - 1600-6135 .- 1600-6143. ; 12:10, s. 2700-2709
- Journal article (peer-reviewed)
Abstract
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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 andgt;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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Cardiac allograft vasculopathy
- everolimus
- inflammation
- virtual histology
- MEDICINE
- MEDICIN
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- ref (subject category)
- art (subject category)
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- Arora, Satish
- Erikstad, I.
- Ueland, T.
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- Ekmehag, Björn
- Jansson, Kjell
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- Eiskjaer, H.
- Bøtker, H. E.
- Mortensen, S.-A.
- Saunamaki, K.
- Gude, E.
- Ragnarsson, A.
- Solbu, D.
- Gullestad, L
- Jansson, Kristin ...
- Aukrust, P
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