title: Transplant vasculopathy is associated with increased AlloMap gene expression score.
abstract: The AlloMap gene expression test is used for the non-invasive detection of rejection in heart transplant recipients. We evaluated the impact of transplant vasculopathy on AlloMap gene expression analysis. A total of 69 heart transplant recipients, mean age 53 years, were evaluated at a mean 35 months post-transplant. AlloMap score was determined on the same day of the endomyocardial biopsies. Twenty patients had evidence of vasculopathy by coronary angiography (vasculopathy group). These were compared to the remaining 49 patients (control group). The vasculopathy group had a longer mean follow-up duration (48.7 vs 28.8 months, p < 0.01), lower left ventricular ejection fraction (51% vs 60%, p < 0.01) and increased use of sirolimus (40% vs 16%, p = 0.034) compared with controls. Using the logistic regression model and bagging bootstrap approach to adjust for the time factor and potential confounders, the vasculopathy group had a significantly higher AlloMap score than the control group (32.2 +/- 3.9 vs 26.1 +/- 6.5, p < 0.001). There was a correlation of AlloMap score with time after transplantation (r = 0.31, p = 0.01). We found transplant vasculopathy to be associated with increased AlloMap score.
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Kaufman Center for Heart Failure, Cleveland, Ohio 44195, USA. yamanim@ccf.org
authors.forename: Mohamad H
authors.initials: MH
authors.lastname: Yamani
authors.forename: David O
authors.initials: DO
authors.lastname: Taylor
authors.forename: E Rene
authors.initials: ER
authors.lastname: Rodriguez
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cook
authors.forename: Lingmei
authors.initials: L
authors.lastname: Zhou
authors.forename: Nicholas
authors.initials: N
authors.lastname: Smedira
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
mesh_terms: D000328:Adult; D001706:Biopsy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics* / Q000503:physiopathology; D004699:Endocardium / Q000473:pathology; D005260:Female; D015870:Gene Expression; D006084:Graft Rejection / Q000473:pathology; D006321:Heart / Q000503:physiopathology; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume