HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schutz, A. Articles by Gokel, J. M. Search for Related Content PubMed PubMed Citation Articles by Schutz, A. Articles by Gokel, J. M.

European Journal of Cardio-Thoracic Surgery, Vol 4, 300-307, Copyright © 1990 by European Association for Cardio-thoracic Surgery

ARTICLES

The influence of rejection episodes on the development of coronary artery disease after heart transplantation

A Schutz, BM Kemkes, C Kugler, C Angermann, N Schad, R Rienmuller, S Fritsch, M Anthuber, P Neumaier and JM Gokel
Department of Cardiac Surgery, University of Munich-Grosshadern, FRG.

Since 1981, 77 of 116 patients undergoing heart transplantation (HTx) have survived from 6 months to 8 years. Graft control involved a total of 871 endomyocardial biopsies (EMB) and 141 angiographies. Sixteen patients developed coronary artery disease (CAD) manifesting itself 7- 60 months after HTx (20.7%). These patients (15 male, 1 female) experienced multiple rejection episodes (RE) and more than half suffered from hypercholesterolaemia and hypertension (n = 10). A mean rejection score (Billingham grading) of greater than 1 (mean = 1.6 +/- 1.1) was calculated in all patients with CAD at the time of angiography or autopsy. By contrast, the mean rejection score ranked less than 1 in patients with undetectable or resolved CAD (means = 0.4 +/- 0.38). This rate is not remarkably different from the rejection score in patients (n = 61) without CAD (mean = 0.2 +/- 0.4). The 8 patients alive (56 +/- 18 months) showed a low number of RE/year (mean = 1.1 +/- 0.4) compared with means = 1 +/- 0.9 in patients without CAD. Eight patients expired within a short period (mean = 31 +/- 26.9) and had a significantly higher number of RE/year (mean = 4.3 +/- 2.9; P less than 0.01 vs. no CAD, CAD alive). Autopsy (n = 6) and angiographic studies (n = 46) demonstrated diffuse, concentric, obliterative arterial disease in all vessels (type A) in 6 patients (RE/yr: mean = +/- 5.5 +/- 2.3), single stenoses in major coronary vessels (type B) in 7 patients and ordinary atherosclerosis (3-vessel disease) comparable to ischaemic heart disease (type C) in 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				M. Yousufuddin, S. Haji, R. C. Starling, E. M. Tuzcu, N. B. Ratliff, D. J. Cook, A. Abdo, Y. Saad, S. S. Karnik, D. Wang, et al. Cardiac angiotensin II receptors as predictors of transplant coronary artery disease following heart transplantation Eur. Heart J., March 1, 2004; 25(5): 377 - 385. [Abstract] [Full Text] [PDF]

				B. Lindelow, C.-H. Bergh, C. Lamm, B. Andersson, and F. Waagstein Graft coronary artery disease is strongly related to the aetiology of heart failure and cellular rejections Eur. Heart J., September 2, 1999; 20(18): 1326 - 1334. [Abstract] [PDF]

				J. Botas, F. J. Pinto, A. Chenzbraun, D. Liang, J. S. Schroeder, S. N. Oesterle, E. L. Alderman, R. L. Popp, and A. C. Yeung Influence of Preexistent Donor Coronary Artery Disease on the Progression of Transplant Vasculopathy : An Intravascular Ultrasound Study Circulation, September 1, 1995; 92(5): 1126 - 1132. [Abstract] [Full Text]

				G. L. Winters, E. Loh, and F. J. Schoen Natural History of Focal Moderate Cardiac Allograft Rejection : Is Treatment Warranted? Circulation, April 1, 1995; 91(7): 1975 - 1980. [Abstract] [Full Text]

				E. M. Tuzcu, R. E. Hobbs, G. Rincon, C. Bott-Silverman, A. C. De Franco, K. Robinson, P. M. McCarthy, R. W. Stewart, S. Guyer, and S. E. Nissen Occult and Frequent Transmission of Atherosclerotic Coronary Disease With Cardiac Transplantation : Insights From Intravascular Ultrasound Circulation, March 15, 1995; 91(6): 1706 - 1713. [Abstract] [Full Text]