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

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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, Björn; Jansson, Kristina; Eiskjaer, H; Bøtker, H E; Mortensen, S-A; Saunamaki, K; Gude, E; Ragnarsson, A; Solbu, D; Aukrust, P; Gullestad, L.

In: American Journal of Transplantation, Vol. 12, No. 10, 2012, p. 2700-2709.

Research output: Contribution to journalArticle

Harvard

Arora, S, Erikstad, I, Ueland, T, Sigurdardottir, V, Ekmehag, B, Jansson, K, Eiskjaer, H, Bøtker, HE, 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, vol. 12, no. 10, pp. 2700-2709. https://doi.org/10.1111/j.1600-6143.2012.04234.x

APA

CBE

Arora S, Erikstad I, Ueland T, Sigurdardottir V, Ekmehag B, Jansson K, Eiskjaer H, Bøtker HE, 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):2700-2709. https://doi.org/10.1111/j.1600-6143.2012.04234.x

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Arora, S ; Erikstad, I ; Ueland, T ; Sigurdardottir, V ; Ekmehag, Björn ; Jansson, Kristina ; Eiskjaer, H ; Bøtker, H E ; Mortensen, S-A ; Saunamaki, K ; Gude, E ; Ragnarsson, A ; Solbu, D ; Aukrust, P ; Gullestad, L. / Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial. In: American Journal of Transplantation. 2012 ; Vol. 12, No. 10. pp. 2700-2709.

RIS

TY - JOUR

T1 - Virtual Histology Assessment of Cardiac Allograft Vasculopathy Following Introduction of Everolimus-Results of a Multicenter Trial.

AU - Arora, S

AU - Erikstad, I

AU - Ueland, T

AU - Sigurdardottir, V

AU - Ekmehag, Björn

AU - Jansson, Kristina

AU - Eiskjaer, H

AU - Bøtker, H E

AU - Mortensen, S-A

AU - Saunamaki, K

AU - Gude, E

AU - Ragnarsson, A

AU - Solbu, D

AU - Aukrust, P

AU - Gullestad, L

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

U2 - 10.1111/j.1600-6143.2012.04234.x

DO - 10.1111/j.1600-6143.2012.04234.x

M3 - Article

VL - 12

SP - 2700

EP - 2709

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 10

ER -