Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial.

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Bibtex

@article{8e70098eb40343bba9e45d7d9b3d19cb,
title = "Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial.",
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 = "S Arora and I Erikstad and T Ueland and V Sigurdardottir and Bj{\"o}rn Ekmehag and Kristina Jansson and H Eiskjaer and B{\o}tker, {H E} and S-A Mortensen and K Saunamaki and E Gude and A Ragnarsson and D Solbu and P Aukrust and L Gullestad",
year = "2012",
doi = "10.1111/j.1600-6143.2012.04234.x",
language = "English",
volume = "12",
pages = "2700--2709",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "10",

}