title: Rapidly progressive cardiac allograft vasculopathy in early onset regressed with everolimus treatment in an adult cardiac recipient.
abstract: A 60-year-old man with severe heart failure underwent an orthotopic heart transplant. Maintenance immunosuppression consisted of a calcineurin inhibitor, mycophenolate mofetil (MMF), and a glucocorticoid. Six months after the transplantation, coronary angiography (CAG) and intravascular ultrasound sonography (IVUS) showed rapidly progressive cardiac allograft vasculopathy (CAV) along with acute cellular rejection. Methylprednisone pulse therapy resulted in the resolution of acute rejection. MMF was exchanged for everolimus (EVL) and 6 months after EVL therapy, CAG and IVUS revealed the regression of CAV. EVL can improve established CAV as well as prevent the progression of CAV.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishida
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.forename: Taro
authors.initials: T
authors.lastname: Shiga
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Masaru
authors.initials: M
authors.lastname: Hatano
authors.forename: Hisataka
authors.initials: H
authors.lastname: Maki
authors.forename: Toshiro
authors.initials: T
authors.lastname: Inaba
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yao
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hirata
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000970:Antineoplastic Agents; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D017023:Coronary Angiography; D000068338:Everolimus; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D018084:Ultrasonography, Interventional
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus