title: Systemic markers of inflammation are associated with cardiac allograft vasculopathy and an increased intimal inflammatory component.
abstract: We evaluated an extensive profile of clinical variables and immune markers to assess the inflammatory milieu associated with cardiac allograft vasculopathy (CAV) assessed by intravascular ultrasound (IVUS) and virtual histology (VH). In total, 101 heart transplant (HTx) recipients were included and underwent IVUS/VH examination and measurement of plasma C-reactive protein (CRP), soluble tumor necrosis factor receptor-1, interleukin-6, osteoprotegerin, soluble gp130, von Willebrand factor, vascular cell adhesion molecule-1 (VCAM-1) and neopterin. Mean Maximal Intimal Thickness (MIT) was 0.61 +/- 0.19 mm and mean fibrotic, fibrofatty, dense calcified and necrotic core components were 55 +/- 15, 14 +/- 10, 15 +/- 13 and 17 +/- 9%, respectively. In multivariate analysis, CRP > 1.5 mg/L (OR 4.6, p < 0.01), VCAM-1 > 391 ng/mL (adjusted OR 3.2, p = 0.04) and neopterin > 7.7 nmol/L (OR 3.8, p = 0.02) were independently associated with MIT > 0.5 mm. Similarly, CRP > 1.5 mg/L (OR 3.7, p < 0.01) and VCAM-1 > 391 (OR 2.7, p = 0.04) were independently associated with an increased intimal inflammatory component (dense calcified/necrotic core component > 30%). Advanced CAV is associated with elevated CRP, VCAM-1 and neopterin and the two former biomarkers are also associated with an increased intimal inflammatory component. Forthcoming studies should clarify if routine measurements of these markers can accurately identify HTx recipients at risk of developing advanced CAV and vulnerable lesions.
authors.affiliation: Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. satish.arora@medisin.uio.no
authors.forename: S
authors.initials: S
authors.lastname: Arora
authors.forename: A
authors.initials: A
authors.lastname: Gunther
authors.forename: B
authors.initials: B
authors.lastname: Wennerblom
authors.forename: T
authors.initials: T
authors.lastname: Ueland
authors.forename: A K
authors.initials: AK
authors.lastname: Andreassen
authors.forename: E
authors.initials: E
authors.lastname: Gude
authors.forename: K
authors.initials: K
authors.lastname: Endresen
authors.forename: O
authors.initials: O
authors.lastname: Geiran
authors.forename: N
authors.initials: N
authors.lastname: Wilhelmsen
authors.forename: R
authors.initials: R
authors.lastname: Andersen
authors.forename: P
authors.initials: P
authors.lastname: Aukrust
authors.forename: L
authors.initials: L
authors.lastname: Gullestad
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D016027:Heart Transplantation; D016041:Heart-Lung Transplantation; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6; D008297:Male; D008875:Middle Aged; D047888:Receptors, Tumor Necrosis Factor, Type I; D014184:Transplantation, Homologous; D017539:Tunica Intima / Q000737:chemistry; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D047888:Receptors, Tumor Necrosis Factor, Type I; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor; D002097:C-Reactive Protein