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Longitudinal evaluation of microvessel density in survivors vs. nonsurvivors of cardiac pathologic antibody-mediated rejection.
- Source :
-
Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology [Cardiovasc Pathol] 2012 Nov-Dec; Vol. 21 (6), pp. 445-54. Date of Electronic Publication: 2012 Feb 29. - Publication Year :
- 2012
-
Abstract
- Background: Antibody-mediated rejection (AMR) of cardiac allografts is associated with reduced long-term graft survival, but not every patient with AMR develops premature graft failure. The tissue level mechanisms leading to graft failure in some patients with antibody-mediated rejection are poorly characterized.<br />Methods: We assessed changes in myocardial microvessel density (number of capillaries per unit area) in endomyocardial biopsies over time using whole-slide microscopic imaging of CD34-stained slides and computer-assisted image analysis. Changes were compared among eight heart transplant recipients with multiple episodes of pathologic AMR who died from cardiovascular causes, eight age- and gender-matched patients with pathologic AMR who were still alive at a similar follow-up interval, and six matched controls without AMR or cellular rejection.<br />Results: Microvessel density decreased in the last biopsies (mean 6.52 years post-transplant) from patients with pathologic AMR and cardiovascular mortality compared to their biopsies at 6 and 12 months post-transplant [respectively, -22% (P=.02) and -25% (P=.02)]. A similar decrease was not seen for the other groups.<br />Conclusions: Significantly reduced myocardial microvessel density does occur in a subset of patients with pathologic AMR who have a worse outcome. These data provide insights into the interplay between AMR, microvascular injury, and clinical outcomes.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Antibodies immunology
Antigens, CD34 metabolism
Biomarkers metabolism
Biopsy
Capillaries metabolism
Coronary Circulation
Coronary Vessels metabolism
Echocardiography
Female
Graft Rejection immunology
Graft Rejection mortality
Heart Diseases pathology
Heart Diseases physiopathology
Heart Diseases surgery
Heart Transplantation immunology
Heart Transplantation mortality
Humans
Image Processing, Computer-Assisted
Immunity, Cellular
Male
Middle Aged
Myocardium immunology
Survival Rate
Utah epidemiology
Young Adult
Capillaries pathology
Coronary Vessels pathology
Graft Rejection pathology
Heart Transplantation pathology
Myocardium pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1336
- Volume :
- 21
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology
- Publication Type :
- Academic Journal
- Accession number :
- 22381397
- Full Text :
- https://doi.org/10.1016/j.carpath.2012.01.004