Efficacy and Safety Of Alirocumab to Prevent Early Cardiac Allograft Vasculopathy in Recent Heart Transplant Recipients

Condition:   Cardiac Allograft Vasculopathy Interventions:   Drug: Alirocumab;   Other: Placebo Sponsors:   Institute for Clinical and Experimental Medicine;   St. Anne's University Hospital Brno, Czech Republic;   Centre of Cardiovascular and Transplantation Surgery, Czech Republic Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials

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We report central invasive haemodynamic parameters at rest and exercise during a 3 year follow‐up after HTx in a sub‐study of the SCandiavian Heart transplant Everolimus De novo stUdy with earLy calcineurin inhibitor avoidancE trial. We hypothesized that the nephroprotective properties, the less development of cardiac allograft vasculopathy (CAV), and the antifibrotic properties of EVR, in comparison with CNI‐based immunosuppression, would demonstrate favourable invasive haemodynamic profiles in patients at rest and during exercise.Methods and resultsNinety of 115 HTx recipients randomized to EVR or CNI treatment per...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
Over the past four decades, cardiac transplantation has achieved considerable success in patients with end-stage heart disease; however, the incidence of antibody-mediated rejection (AMR) remains high and is considered to be an important cause of life-threatening cardiac allograft dysfunction.1-3
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Pre-Clinical Science Source Type: research
Abstract BACKGROUND: Because of the growing prevalence of terminal heart failure on the one hand and organ shortage on the other hand, an optimal care of heart transplant recipients based on the knowledge of potential risk factors not only early, but also in a long-term course after heart transplantation is of great importance. Therefore, the aim of the present study was to identify predisposing factors for late mortality in this patient collective. METHODS: Data from long-term heart transplant patients collected during follow-up visits in the current center were retrospectively analyzed. Clinical, laboratory...
Source: Cardiology Journal - Category: Cardiology Authors: Tags: Cardiol J Source Type: research
AbstractReversible cerebral vasoconstriction syndrome (RCVS) after heart transplantation is a rare, but serious complication, because of a high risk for permanent neurological deficits or allograft rejection. A 48-year-old female who underwent orthotropic heart transplantation presented with a sudden severe headache 10  days after transplantation. Although magnetic resonance angiography (MRA) findings at initial symptom onset were normal, MRA finding at the next day revealed multifocal vasoconstriction of cerebral arteries. Tacrolimus-induced RCVS was strongly suspected, and tacrolimus was immediately discontinue d an...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusion: LVMI reversed and MAP and renal function were normalized early after transplantation of a healthy kidney. However, LV fibrosis persisted, dissociating LV hypertrophy from LV fibrosis within 6 weeks. Elucidating cardiac ECM dynamics in CKD patients, although challenging, appears promising.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Organ damage Source Type: research
Abstract Indoleamine 2, 3-dioxygenase (IDO)-mediated regulation of tryptophan metabolism plays an important role in immune tolerance in transplantation, but it has not been elucidated which mechanism specifically induces the occurrence of immune tolerance. Our study revealed that IDO exerts immunosuppressive effects through two pathways in mouse heart transplantation, 'tryptophan depletion' and 'tryptophan metabolite accumulation'. The synergism between IDO+ DC and TC (tryptophan catabolic products) has stronger inhibitory effects on T lymphocyte proliferation and mouse heart transplant rejection than the two inte...
Source: J Cell Mol Med - Category: Molecular Biology Authors: Tags: J Cell Mol Med Source Type: research
We describe a ca se series in which 2 patients received kidney transplants while on veno‐arterial ECMO support for PGD after heart transplant. Both patients are alive more than 1 year following transplant, with good cardiac and renal function and no signs of cardiac rejection. Kidney transplant surgery is safe for patients on veno‐arterial ECMO support for cardiac PGD. It allows the heart recipient to receive a kidney from the same donor with both immunologic and survival advantages.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
Conclusion: Quantitative PET analysis, and particularly MFR, has diagnostic and prognostic utility after heart transplantation. Preserved MFR identifies low-risk patients, whereas the presence of multiple abnormal parameters identifies high-risk patients.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Source Type: research
We read with great interest the article by Van Keer et al. assessing the long term outcomes of cardiac allograft vasculopathy (CAV).1 We commend the authors on their large well-characterized dataset over a 25-year period, and for contributing knowledge on an important disease we do not yet fully understand. Importantly, this is one of the largest analysis and external validation of the ISHLT CAV classification system.2 We believe a few points merit further consideration.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Case Anecdotes, Comments and Opinions Source Type: research
AbstractPurpose of ReviewCardiac allograft vasculopathy (CAV) is a significant cause of morbidity and mortality in the post-cardiac transplant patient population. Current guidelines recommend annual angiographic surveillance for CAV; however, angiography alone has several limitations and can lead to systematic underestimation of disease burden and the inability to sensitively track disease progression. We provide an overview of intravascular imaging in the initial and longitudinal evaluation of CAV, with a focus on the use of intravascular ultrasound (IVUS).Recent FindingsMultiple studies have demonstrated that progression...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
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