Elevated Donor-Derived Cell-Free DNA Levels Are Associated With Reduced Myocardial Blood Flow but Not Angiographic Cardiac Allograft Vasculopathy: The EVIDENT Study
Authors' conclusion
HT recipients with angiographic CAV had similar dd-cfDNA levels and rates as those without. Notably, dd-cfDNA levels and rates were significantly elevated in patients with RMBF assessed by positron emission tomography compared with those with normal MBF.
Study context
- Population
- Heart transplant recipients undergoing donor-derived cell-free DNA (dd-cfDNA) testing and cardiac allograft vasculopathy (CAV) screening with cardiac PET and coronary angiography, September 2019–November 2022median 8 years post-HT
- Participants
- 256 recipients
- Exposure
- Angiographic CAV vs no CAV; reduced myocardial blood flow (MBF) vs normal MBF
- Outcome
- Elevated dd-cfDNA (≥0.12%): prevalence and level
Methodological detailssingle high-volume centre
- Single high-volume centre
Main finding
As reported in the abstract
Positive dd-cfDNA test and dd-cfDNA level
| Group | Value | dd-cfDNA median (IQR) |
|---|---|---|
| CAV | 29% | 0.26% [IQR, 0.15%-0.62%] |
| No CAV | 30% | 0.31% [IQR, 0.17%-0.71%] |
| Reduced MBF (RMBF) | 51% | 0.81% [IQR, 0.48%-1.11%] |
| Normal MBF | 27% | 0.25% [IQR, 0.15%-0.52%] |
Value
CAV29%
No CAV30%
Reduced MBF (RMBF)51%
Normal MBF27%
dd-cfDNA median (IQR)
CAV0.26% [IQR, 0.15%-0.62%]
No CAV0.31% [IQR, 0.17%-0.71%]
Reduced MBF (RMBF)0.81% [IQR, 0.48%-1.11%]
Normal MBF0.25% [IQR, 0.15%-0.52%]
- CAV vs No CAV: P = 0.94 — prevalence of positive test
- CAV vs No CAV: P = 0.38 — median level
- RMBF vs Normal MBF: P < 0.001 — prevalence of positive test
- RMBF vs Normal MBF: P < 0.001 — median level
Observational data: associations, not effects.
Further findings
| Outcome | RMBF | Normal MBF | P value |
|---|---|---|---|
| Ischemic etiology of HFRMBF vs Normal MBF | 36% | 20% | P = 0.02 |
Original publication
Elevated Donor-Derived Cell-Free DNA Levels Are Associated With Reduced Myocardial Blood Flow but Not Angiographic Cardiac Allograft Vasculopathy: The EVIDENT Study. Circ Heart Fail. Published 10 December 2024. doi:10.
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