Quilty Indicates Increased Risk for Microvasculopathy and Poor Survival After Heart Transplantation

Hiemann, N.E.; Knosalla, Christoph; Wellnhofer, Ernst; Lehmkuhl, H.; Hetzer, Roland; Meyer, Rudolf

doi:10.1016/j.healun.2007.11.573

Cited by 23 publications

(14 citation statements)

References 39 publications

(41 reference statements)

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“…It should be also noted that some investigators have described QE as a marker of poor survival in OHT recipients. 16,17 We found no correlation between QE occurrence and CAV development, either by considering any lesions that can be found in coronary angiography or by calculating the only clinically significant form of coronary disease. Our results sharply contrast with the research of many investigators who were able to prove a significant correlation between QE and the incidence of transplant coronary artery disease.…”

Section: Discussionmentioning

confidence: 72%

“…Our results sharply contrast with the research of many investigators who were able to prove a significant correlation between QE and the incidence of transplant coronary artery disease. 4,17,18 There are some limitations to the present study, the majority of which were imposed by its retrospective character. However, we do believe that the thorough medical history of our patients allowed us to minimize the effects of these limitations.…”

Section: Discussionmentioning

confidence: 97%

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Quilty Effect Correlates With Biopsy-proven Acute Cellular Rejection But Does Not Predict Transplanted Heart Coronary Artery Vasculopathy

Zakliczyński¹,

Nożyński²,

Konecka-Mrowka³

et al. 2009

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 97%

Quilty Effect Correlates With Biopsy-proven Acute Cellular Rejection But Does Not Predict Transplanted Heart Coronary Artery Vasculopathy

Zakliczyński¹,

Nożyński²,

Konecka-Mrowka³

et al. 2009

The Journal of Heart and Lung Transplantation

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“…In our study we have not confirmed a correlation between Quilty effect (endocardial infiltration of lymphocytes) and atherosclerosis. In published studies the significance of the Quilty effect was not proved either [17,18].…”

Section: Discussionmentioning

confidence: 96%

Coronary artery disease in patients after orthotopic heart transplantation treated with percutaneous coronary intervention – a single centre experience

Sobieszczańska−Małek¹,

Zieliński²,

Karcz³

et al. 2010

pwki

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A b s t r a c tBackground: Some patients after orthotopic heart transplantation (OHT) develop coronary focal lesions and may need interventional therapy.Aim: To determine the frequency and time course of narrowing of epicardial coronary arteries in transplanted hearts, potential risk factors and results of percutaneous coronary interventions.Methods and results: Demographic and coronary angiography data of 265 patients after OHT, mean age 53.0 ±14.6, were analysed. Significant focal narrowing of the coronary artery was diagnosed when there was a decrease of 50% or more of the lumen of the coronary artery. Mean time from OHT to the end of observation was 6.2 ±4.5 (range 0.5-23) years. Thirty-six (14%) patients after OHT had significant focal changes in coronary arteries. In 16 patients the degree of stenosis, lesion, location or calibre of the vessel was not suitable for interventional therapy. Twenty (55%; 18 men) patients underwent coronary intervention. Mean age of patients during coronary intervention was 53.5 ±9.8 years and of those without intervention at the end of observation was 52.5 ±14.9 years (NS). In patients with intervention mean time from OHT to intervention was 7.0 ±4.6 years. In patients with coronary intervention mean time from OHT to the end of observation was 10.8 ±6.5 years and in patients without intervention 5.8 ±4.1 (p < 0.001). Analysis of Kaplan-Meier curves showed that probability of coronary stenosis-free survival diminishes rapidly after 5 years following OHT. Patients who required coronary intervention had significantly higher hsCRP as compared to those without intervention (0.720 vs. 0.044, p = 0.025). There were no statistical differences between the two groups in cholesterol level, BMI or incidence of diabetes, number of acute cellular episodes or Quilty effect.Conclusions: Significant focal coronary stenoses are found mainly more than 5 years post heart transplantation. Most patients can be treated safely and effectively with percutaneous coronary intervention with contrast-induced nephropathy prophylaxis. Risk factors of coronary vasculopathy post OHT require further investigations.Key words: vasculopathy, heart transplantation, coronary artery disease, percutaneous coronary intervention S t r e s z c z e n i e Wstęp: U pacjentów po transplantacji serca (OHT) mogą się rozwijać zmiany w naczyniach wieńcowych, które niejednokrotnie wymagają leczenia interwencyjnego.Cel: Ocena przebiegu zmian w naczyniach wieńcowych, potencjalnych czynników ryzyka oraz wyników leczenia przezskórną angioplastyką wieńcową.Metody i wyniki: Analizie poddano badania koronarograficzne 265 pacjentów w wieku średnio 53,0 ±14,6 roku. Za istotne zmiany w naczyniach wieńcowych przyjęto zwężenie światła naczynia powyżej 50%. Interwencję (angioplastykę) wykonywano przy zwę-żeniu powyżej 70%. W przypadkach pośrednich wykonywano ultrasonograficzną ocenę światła naczyń wieńcowych. Średni czas od

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“…Hiemann с соавт. [10] также чаще находили у женщин инфильтрацию эндокарда трансплантированного сердца лимфоидными клетками (p = 0,038). Противоположно мнение A. Joshi с соавт.…”

unclassified

“…[7], которые считают, что частота развития эффекта Quilty не зависит от пола пациентов. Больные, у которых в эндомиокардиальных биоптатах находили Quilty-повреждение, были значительно моложе пациентов, у которых отсутствовало воспаление эндокарда [6,10,12]. Между эффектом Quilty и степенью совместимости по HLA донора и реципиента, а также выработкой антител против HLA в посттрансплантационном периоде не было выявлено корреляции [12].…”

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Etiology, Pathogenesis and Morphology of the Quilty Effect

Alexeeva¹,

Iljinsky²

2015

Russian Journal of Transplantology and Artificial Organs

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ФГБУ «ФНЦ трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, г. Москва 2 Кафедра трансплантологии и искусственных органов I МГМУ имени И.М. Сеченова, г. Москва Несмотря на то что изучение эндокардиальных инфильтратов (Quilty effect) в трансплантированном сердце продолжается уже более 30 лет, этиология, морфология и клиническое значение этого феномена остаются до конца не выясненными. В статье приведены данные доступной литературы о возможных причинах и механизмах развития эффекта Quilty, а также о его влиянии на функцию трансплантированного сердца.

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Quilty Indicates Increased Risk for Microvasculopathy and Poor Survival After Heart Transplantation

Cited by 23 publications

References 39 publications

Quilty Effect Correlates With Biopsy-proven Acute Cellular Rejection But Does Not Predict Transplanted Heart Coronary Artery Vasculopathy

Quilty Effect Correlates With Biopsy-proven Acute Cellular Rejection But Does Not Predict Transplanted Heart Coronary Artery Vasculopathy

Coronary artery disease in patients after orthotopic heart transplantation treated with percutaneous coronary intervention – a single centre experience

Etiology, Pathogenesis and Morphology of the Quilty Effect

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