Noninvasive diagnosis of cardiac allograft rejection. Another of many searches for the grail.

Hosenpud, J.D.

doi:10.1161/01.cir.85.1.368

Cited by 40 publications

(10 citation statements)

References 19 publications

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“…Unlike in the case of 99m Tc-pyrophosphate, a large amount of data support the clinical use of 111 In-antimyosin for the detection of acute or chronic diffuse myocardial damage in several clinical settings other than MI, such as allograft rejection in cardiac transplant recipients [25,26,27,28,29], doxorubicin-induced cardiotoxicity [20,30,31,32], acute myocarditis [19,33,34,35], various cardiomyopathies [21,36,37,38,39] or diseases secondary to myocardial involvement [40,41,42,43,44]. The performance of 111 In-antimyosin scanning in pathological conditions characterised by ongoing and diffuse myocardial necrosis is of potential clinical value considering that the serum concentration of the biological markers of myocardial injury may not be sufficient for the diagnosis or staging of the damage in these heart diseases.…”

Section: In-antimyosinmentioning

confidence: 99%

Non-invasive in vivo imaging of myocardial apoptosis and necrosis

Flotats

Carrió

2003

Eur J Nucl Med Mol Imaging

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Myocardial necrosis plays an important role in the pathogenesis of various cardiovascular disorders and can result from different myocardial insults. Its non-invasive identification and localisation therefore may help in the diagnosis of these disorders, as well as in prognosis and assessment of treatment response. Apoptosis, or programmed cell death, is important in the spectrum of myocardial damage since it is gradually becoming more apparent that cell death may begin as apoptosis and not as necrosis. First attempts to directly visualise the area of myocardial necrosis were based on recognition of myocardial infarction with "hot spot imaging agents" in patients with chest pain. Since then, the study of myocardial necrosis with gamma imaging agents has gone beyond the detection of myocardial infarction, and attempts have been made to diagnose other cardiovascular disorders associated with cardiac cell death such as heart transplant rejection, myocarditis, cardiotoxicity and cardiomyopathies. Traditionally, two hot spot imaging agents have been used for the detection of myocardial necrosis, (99m)Tc-pyrophosphate and (111)In-antimyosin. In addition, preliminary studies have demonstrated promising results with (99m)Tc-glucarate. Recently, (99m)Tc-annexin V has been successfully used for non-invasive gamma imaging of apoptosis after acute myocardial infarction, acute myocardial ischaemia, acute cardiac allograft rejection and malignant intracardiac tumours. This review article focusses on the characteristics of these different myocardial necrotic and apoptotic markers and compares their role in the assessment of myocardial damage.

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Section: In-antimyosinmentioning

confidence: 99%

Non-invasive in vivo imaging of myocardial apoptosis and necrosis

Flotats

Carrió

2003

Eur J Nucl Med Mol Imaging

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“…Also various biochemical markers, such as neopterines [ 3 ], prolactin [ 4 ], urinary polyamines [ 5 ], beta 2-microglobulins [ 6 ] and brain natriuretic peptide (BNP) [ 7 ] have been suggested for this purpose. However, none of the above methods or markers has proven sensitive or specific enough to replace endomyocardial biopsy [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of CXCL9 and CXCL10 as circulating biomarkers of human cardiac allograft rejection

Karason

Jernås

Hägg

et al. 2006

BMC Cardiovasc Disord

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“…For the cytoimmunologic monitoring which was based primarily on the visual detection of lymphoblasts and activated lymphocytes in cytospins of a mononuclear concentrate of peripheral blood [3,4], high sensitivities and specificities in a range over 90% were reported [4]. These results could not be reproduced by others [5,6], even when the monitoring was supplemented by flow cytometric, immunophenotypic detection of activated forms of lymphocytes. The issue of whether or not the cytoimmunologic monitoring provided a valuable diagnostic information after heart transplantation is unresolved up to now.…”

Section: Discussionmentioning

confidence: 99%

“…They reported a high sensitivity and specificity for rejection detection by visual counting of lymphoblasts and activated lymphocytes in a stained cytospin of concentrated mononuclear blood cells. Others, however, could not reproduce the favorite results of these groups by using the same morphologically based approach or by immunophenotyping of activated lymphocytes by flow cytometry [5,6]. All body organs permanently shed soluble class I MHC antigens which can easily be detected in the circulation by enzyme immunoassay.…”

Section: Introductionmentioning

confidence: 99%

Immunologic Monitoring for Rejection Diagnosis during the First Three Months after Heart Transplantation

Prohaska¹,

Körner²,

Köster-Eiserfunke³

et al. 1998

Transfus Med Hemother

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Objective: Determination of lymphocyte subset alterations during the early phase after heart transplantation. Comparison of lymphocyte activation parameters and concentrations of soluble class I MHC molecules with the established endomyocardial biopsy rejection grading results. Patients and Methods: 154 heart transplant patients with 382 endomyocardial biopsies during the first 3 months after transplantation. The following statistical data were calculated: sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency (sum of true-positive and true-negative results as a part of total results). The immunophenotyping by flow cytometry includes CD4+, CD8+, CD3/HLA-DR+, CD8/HLA-DR+ and CD4/CD25+ subsets. The activation index (activated lymphocytes defined by microscopy after staining) was also determined. Results: By shifting the cut-off of lymphocyte subsets to higher cell concentrations, the positive predictive values increased, reaching 60–100% for some parameters. However, the overall diagnostic efficiency was considerably lower: activation index 54%, CD8/HLA-DR+ 58%, CD3/HLA-R+ 57%, CD4/CD25+ 49%, and CD4/CD8-ratio 46%. The determination of soluble class I MHC molecules in plasma samples drawn during rejection episodes and in rejection-free periods in a group of 53 heart transplant patients showed no differences between the periods. Conclusions: Immunophenotyping by flow cytometry or cytology for detection of activated T lymphocytes in peripheral blood has a low overall diagnostic efficiency in rejection diagnosis. The determination of soluble class I MHC molecules seems to be of no value for the early detection of rejection.

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Noninvasive diagnosis of cardiac allograft rejection. Another of many searches for the grail.

Cited by 40 publications

References 19 publications

Non-invasive in vivo imaging of myocardial apoptosis and necrosis

Non-invasive in vivo imaging of myocardial apoptosis and necrosis

Evaluation of CXCL9 and CXCL10 as circulating biomarkers of human cardiac allograft rejection

Immunologic Monitoring for Rejection Diagnosis during the First Three Months after Heart Transplantation

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