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Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important?
BACKGROUND: The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL/METHODS: There were 147...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248309/ https://www.ncbi.nlm.nih.gov/pubmed/29146891 http://dx.doi.org/10.12659/AOT.905267 |
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author | Sobieszczańska-Małek, Małgorzata Korewicki, Jerzy Komuda, Krzysztof Karczmarz, Małgorzata Szymańska, Sylwia Cicha-Mikołajczyk, Alicja Bekta, Paweł Parulski, Adam Pronicki, Maciej Grajkowska, Wiesława Małek, Grzegorz Leszek, Przemysław Kaczorowska, Maria Kuśmierczyk, Mariusz Zieliński, Tomasz |
author_facet | Sobieszczańska-Małek, Małgorzata Korewicki, Jerzy Komuda, Krzysztof Karczmarz, Małgorzata Szymańska, Sylwia Cicha-Mikołajczyk, Alicja Bekta, Paweł Parulski, Adam Pronicki, Maciej Grajkowska, Wiesława Małek, Grzegorz Leszek, Przemysław Kaczorowska, Maria Kuśmierczyk, Mariusz Zieliński, Tomasz |
author_sort | Sobieszczańska-Małek, Małgorzata |
collection | PubMed |
description | BACKGROUND: The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL/METHODS: There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest). RESULTS: CAV was recognized in 48 patients (CAV group); mean age 53.6±13.6 years. There were 99 patients without CAV (nonCAV group); mean age 48.3±15.5 years. A univariate Cox analysis of the development of coronary disease showed statistical significance (p<0.05) for baseline high-density lipid (HDL), ACR, AMR, CMV, and donor age. Multivariate Cox regression model confirmed that only baseline HDL, episodes of ACR, donor age, and CMV infection are significant for the frequency of CAV after HT. CONCLUSIONS: Older donor age is highly associated with CAV development. Older donor age and low level of HDL in heart recipients with the strongest influence of immunologic risk factors (ACR, CMV infection) were linked with development of CAV. |
format | Online Article Text |
id | pubmed-6248309 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62483092018-11-28 Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? Sobieszczańska-Małek, Małgorzata Korewicki, Jerzy Komuda, Krzysztof Karczmarz, Małgorzata Szymańska, Sylwia Cicha-Mikołajczyk, Alicja Bekta, Paweł Parulski, Adam Pronicki, Maciej Grajkowska, Wiesława Małek, Grzegorz Leszek, Przemysław Kaczorowska, Maria Kuśmierczyk, Mariusz Zieliński, Tomasz Ann Transplant Original Paper BACKGROUND: The aim of this study was to find the main risk factors for development of cardiac allograft vasculopathy (CAV), especially factors identified before the surgical procedure and factors related to the recipient profile and the medical history of the donor. MATERIAL/METHODS: There were 147 patients who had heart transplantation (HT) included in this study: mean age was 45.8±15.3 years. All study patients had coronary angiography after HT. Analyzed risk factors were: non-immunologic recipient risk factors (age of transplantation, smoking, hypertension, lipids, diabetes, obesity and weight gain after HT), immunologic recipient risk factors (acute cellular rejection (ACR), acute humoral rejection (AMR), cytomegalovirus (CMV) episodes), and donor-related risk factors (age, sex, catecholamine usage, ischemic time, compatibility of sex and blood groups, cause of death, cardiac arrest). RESULTS: CAV was recognized in 48 patients (CAV group); mean age 53.6±13.6 years. There were 99 patients without CAV (nonCAV group); mean age 48.3±15.5 years. A univariate Cox analysis of the development of coronary disease showed statistical significance (p<0.05) for baseline high-density lipid (HDL), ACR, AMR, CMV, and donor age. Multivariate Cox regression model confirmed that only baseline HDL, episodes of ACR, donor age, and CMV infection are significant for the frequency of CAV after HT. CONCLUSIONS: Older donor age is highly associated with CAV development. Older donor age and low level of HDL in heart recipients with the strongest influence of immunologic risk factors (ACR, CMV infection) were linked with development of CAV. International Scientific Literature, Inc. 2017-11-17 /pmc/articles/PMC6248309/ /pubmed/29146891 http://dx.doi.org/10.12659/AOT.905267 Text en © Ann Transplant, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Original Paper Sobieszczańska-Małek, Małgorzata Korewicki, Jerzy Komuda, Krzysztof Karczmarz, Małgorzata Szymańska, Sylwia Cicha-Mikołajczyk, Alicja Bekta, Paweł Parulski, Adam Pronicki, Maciej Grajkowska, Wiesława Małek, Grzegorz Leszek, Przemysław Kaczorowska, Maria Kuśmierczyk, Mariusz Zieliński, Tomasz Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? |
title | Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? |
title_full | Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? |
title_fullStr | Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? |
title_full_unstemmed | Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? |
title_short | Heart Transplantation and Risk of Cardiac Vasculopathy Development: What Factors Are Important? |
title_sort | heart transplantation and risk of cardiac vasculopathy development: what factors are important? |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248309/ https://www.ncbi.nlm.nih.gov/pubmed/29146891 http://dx.doi.org/10.12659/AOT.905267 |
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