Heart failure & cardiomyopathies
Heart Transplantation and Anti-HLA antibodY: Myocardial Dysfunction and Prognosis - HeartLAy Study
Authors' conclusion
The presence of circulating anti-HLA antibodies is correlated with a mild cardiac dysfunction, even in the absence of AMR, and CAV development. Interestingly, reduced values of DecT E and fwRVLS were predictors of future development of CAV, independently from anti-HLA antibody.
Study context
- Population
- Heart-transplanted patients without acute cellular rejection, antibody-mediated rejection or cardiac allograft vasculopathy
- Participants
- 113 patients
- Exposure
- HLA+ vs HLA-
- HLA+n = 50
- HLA-n = 63reference
- Outcome
- Non-invasive parameters of early myocardial dysfunction and their prognostic impact (antibody-mediated rejection (AMR), acute cellular rejection (ACR), CAV, mortality)
- Follow-up
- 2 years
Main finding
As reported in the abstract
Laboratory and echocardiographic markers of myocardial dysfunction
- NT-proBNP significantly higher in HLA+
- P < 0.001
- High-sensitivity cardiac troponin significantly higher in HLA+
- P = 0.003
- Deceleration time of E wave differed
- P < 0.001
- LV global longitudinal strain differed
- P < 0.001
- Tricuspid annular plane systolic excursion differed
- P = 0.011
- Tricuspid S' wave differed
- P = 0.002
- Free wall RV longitudinal strain differed
- P = 0.027
- Left atrial strain did not differ significantly
- P = 0.408
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| CAV development (univariate) · 1 and 2 year follow-upHLA+vs HLA-1 year · univariate analysis | 11.90 (1.43–90.79) | P = 0.022 | |
| CAV development (univariate) · 1 and 2 year follow-upHLA+vs HLA-2 year · univariate analysis | 3.37 (1.78–9.67) | P = 0.024 | |
| 0.050.21520Odds ratio (log scale) |
Predictors of cardiac allograft vasculopathy (CAV) development (bivariate)
- Free wall right ventricular longitudinal strain (fwRVLS) and DecT E predicted CAV development independently from HLA status
Original publication
Heart Transplantation and Anti-HLA antibodY: Myocardial Dysfunction and Prognosis - HeartLAy Study. ESC Heart Fail. Published 6 July 2023. doi:10.
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