Usefulness of von Willebrand factor in cardiac allograft vasculopathy: preliminary experience.
BACKGROUND
Cardiac allograft vasculopathy (CAV) is a disease that significantly limits the survival of transplant patients intravascular ultrasound (IVUS) is considered the method of choice for its diagnosis. von Willebrand factor (vWf) has been used as a marker of endothelial malfunction. We sought to evaluate the usefulness of vWf as a CAV marker.


METHODS
We prospectively analyzed 22 cardiac transplant subjects, on whom we performed a first study using coronary angiography and IVUS at 36 +/- 3 days and a second study at 598 +/- 49 days. During the follow-up period, five vWf serum controls were performed per patient. We analyzed the results with the repeated-measures ANOVA test and a ROC curve.


RESULTS
CAV was detected in 10 (45.5%) of the 22 patients. Although vWf levels tended to diminish progressively during evolution, this trend was not statistically significant (P = .3). However, differences were appreciated based on the presence versus absence of CAV (298 +/- 139 mg/dL versus 212 +/- 105 mg/dL, P = .02). The ROC curve showed a sensitivity of 40%, a specificity of 83%, and a negative predictive value of 82% with a cutoff point of 300 mg/dL.


CONCLUSIONS
Subjects with CAV showed significantly higher vWf serum concentrations, particularly during the preliminary phases of cardiac transplantation decreasing during its evolution. This marker could be useful for early screening of CAV.
Chamorro
C I
CI
Cardiac Failure and Transplant Unit, La Fe University Hospital, Valencia, Spain. carlosisra@ono.com
Almenar
L
L
Martínez-Dolz
L
L
Reganon
E
E
Sánchez-Lacuesta
E
E
Villa
P
P
Ten
F
F
Andrés
L
L
Martínez-Sales
V
V
Salvador
A
A
D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016027:Heart Transplantation / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014184:Transplantation, Homologous; D014652:Vascular Diseases / Q000097:blood*; D014841:von Willebrand Factor / Q000032:analysis*
D015415:Biomarkers; D014841:von Willebrand Factor