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Nozica N, Asatryan B, Aur S, Clement JB, Schwerzmann M, Guan F, Pascale P, Gass M, Duru F, Reichlin T, Pruvot E, Wolber T, Roten L. Arrhythmias and Clinical Outcomes in a Swiss Multicenter Cohort of Patients With Dextro-Transposition of the Great Arteries and Atrial Switch. J Am Heart Assoc 2023:e028956. [PMID: 37345794 DOI: 10.1161/jaha.122.028956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Background Data on the incidence of arrhythmias, associated cardiac interventions, and outcome in patients with dextro-transposition of the great arteries and atrial switch are scarce. Methods and Results In this multicenter analysis, we included adult patients with dextro-transposition of the great arteries and atrial switch regularly followed up at 3 Swiss tertiary care hospitals. The primary outcome was a composite of left ventricular assist device, heart transplantation, and death. The secondary outcome was occurrence of ventricular tachycardia, ventricular fibrillation, or sudden cardiac death. We identified 207 patients (34% women; median age at last follow-up, 35 years) with dextro-transposition of the great arteries and atrial switch. Arrhythmias occurred in 97 patients (47%) at a median age of 22 years. A pacemaker or an implantable cardioverter-defibrillator was implanted in 39 (19%) and 13 (6%) patients, respectively, and 33 (16%) patients underwent a total of 51 ablation procedures to target 60 intra-atrial re-entry tachycardias, 4 atrioventricular nodal re-entry tachycardias, and 1 atrial fibrillation. The primary outcome occurred in 21 patients (10%), and the secondary outcome occurred in 18 patients (9%); both were more common in patients with concomitant ventricular septum defect than in those without (hazard ratio [HR], 3.06 [95% CI, 1.29-7.27], P=0.011; and HR, 3.62 [95% CI, 1.43-9.18], P=0.007, respectively). Conclusions In patients with dextro-transposition of the great arteries and atrial switch reaching adulthood, arrhythmias occur in almost half of patients, and associated rhythm interventions are frequent. One-tenth of those patients do not survive until the age of 35 years free from left ventricular assist device or heart transplantation, and the outcome is worse in patients with concomitant ventricular septum defect.
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Affiliation(s)
- Nikolas Nozica
- Department of Cardiology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - Babken Asatryan
- Department of Cardiology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - Stefania Aur
- Department of Cardiology Centre Hospitalier Universitaire Vaudois University of Lausanne Lausanne Switzerland
| | - Judith Bouchardy Clement
- Department of Cardiology Centre Hospitalier Universitaire Vaudois University of Lausanne Lausanne Switzerland
| | - Markus Schwerzmann
- Department of Cardiology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - Fu Guan
- Department of Cardiology Zurich University Hospital University of Zurich Zurich Switzerland
| | - Patrizio Pascale
- Department of Cardiology Centre Hospitalier Universitaire Vaudois University of Lausanne Lausanne Switzerland
| | - Matthias Gass
- Department of Cardiology Zurich University Hospital University of Zurich Zurich Switzerland
- Department of Cardiology University Children's Hospital Zurich Zurich Switzerland
| | - Firat Duru
- Department of Cardiology Zurich University Hospital University of Zurich Zurich Switzerland
- Center for Integrative Human Physiology University of Zurich Zurich Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital Bern University Hospital University of Bern Bern Switzerland
| | - Etienne Pruvot
- Department of Cardiology Centre Hospitalier Universitaire Vaudois University of Lausanne Lausanne Switzerland
| | - Thomas Wolber
- Department of Cardiology Zurich University Hospital University of Zurich Zurich Switzerland
- Center for Integrative Human Physiology University of Zurich Zurich Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital Bern University Hospital University of Bern Bern Switzerland
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Godinho R, Nowacka A, Aur S, Regamey J, Ltaief Z, Rusca M, Hullin R, Liaudet L, Kirsch M, Yerly P. Safety of Levosimendan Infusion Before LVAD Implantation. A Retrospective Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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3
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Godinho R, Nowacka A, Aur S, Regamey J, Ltaief Z, Rusca M, Hullin R, Liaudet L, Kirsch M, Yerly P. Preoperative Levosimendan to Reduce Risk of Right Ventricular Failure after LVAD Surgery. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Hullin R, Tzimas G, Barras N, Abdurashidova T, Soborun N, Aur S, Regamey J, Hugelshofer S, Lu H, Crisinel V, Daux A, Vinet E, Mekoa‐Mbarga SJ, Kirsch M, Müller O, Hugli O, Monney P. Decongestion improving right heart function ameliorates prognosis after an acute heart failure episode. ESC Heart Fail 2022; 9:3814-3824. [PMID: 35923106 PMCID: PMC9773654 DOI: 10.1002/ehf2.14077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prognostic role of decongestion-related change of cardiac morphology and in particular right heart function has not been investigated comprehensively in AHF patients. METHODS AND RESULTS This prospective observational single-centre study included consecutive patients hospitalized for treatment of AHF with reduced, mildly-reduced or preserved left ventricular ejection fraction (LVEF). Comprehensive transthoracic echocardiography at admission and discharge assessed decongestion-related change of cardiac function and morphology. The combined endpoint of 1 year all-cause mortality and cardiovascular rehospitalization explored the prognostic importance of decongestion-related change. The 176 study participants were 83 years old [74-87] and 54% were men. Fifty one (29%) had rLVEF, 65 (37%) mrLVEF, and 60 (34%) pLVEF. The proportion of de novo or worsening chronic HF was not different between LVEF groups. HF aetiology and cardiovascular risk factors were equally distributed across all groups except for a higher BMI in the pLVEF group. Decongestion equally reduced body weight, heart rate, systolic and diastolic blood pressure, tricuspid regurgitation gradient, and inferior vena cava diameter across all groups (P < 0.004 for all). Decongestion-related increase in TAPSE independent of the LVEF was associated with improvement of right-ventricular-pulmonary artery coupling and a lower incidence of the combined outcome in the Cox proportional hazard risk analysis (unadjusted HR 0.50 95% CI 0.33-0.78, P = 0.002; adjusted HR 0.46 95% CI: 0.33-0.78, P = 0.001). CONCLUSIONS Decongestion-related increase in TAPSE and recovery of RV/pulmonary artery coupling was observed across all LVEF groups and associated with a risk reduction for the combined endpoint highlighting the important prognostic role of right heart recovery after an AHF episode.
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Affiliation(s)
- Roger Hullin
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Georgios Tzimas
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Nicolas Barras
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Tamila Abdurashidova
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Nisha Soborun
- Department of Cardiac Surgery, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Stefania Aur
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Julien Regamey
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Sarah Hugelshofer
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Henri Lu
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Vanessa Crisinel
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Aurelien Daux
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Elise Vinet
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | | | - Matthias Kirsch
- Department of Cardiac Surgery, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Olivier Müller
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Olivier Hugli
- Emergency DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Pierre Monney
- Department of Cardiology, Cardiovascular DepartmentLausanne University Hospital and University of LausanneLausanneSwitzerland
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Nozica N, Asatryan B, Aur S, Greutmann M, Schwerzmann M, Bouchardy J, Gass M, Duru F, Pascale P, Reichlin T, Pruvot E, Wolber T, Roten L. Arrhythmia burden, rhythm interventions and outcome in a large Swiss multicenter population of d-TGA patients with atrial switch. Europace 2022. [DOI: 10.1093/europace/euac053.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Patients with dextro-transposition of the great arteries (d-TGA) and atrial switch face a high life-time risk of arrhythmias.
Purpose
To describe the incidence of arrhythmias, associated cardiac interventions and outcome in a large Swiss population of patients with d-TGA and atrial switch.
Methods
In this multicenter analysis we included all consecutive patients with d-TGA and atrial switch treated at three Swiss tertiary care hospitals. The primary outcome was survival free from left ventricular assist device (LVAD), heart transplantation (HTx) and death. The secondary outcome was survival free from ventricular tachycardia, ventricular fibrillation and sudden cardiac death.
Results
We identified 207 patients (34% females; median age at last follow-up 35 years) with d-TGA and atrial switch. Arrhythmias occurred in 97 patients (47%) at a median age of 22 years. A pacemaker or an implantable cardioverter/defibrillator was implanted in 39 (19%) and 13 (6%) patients, respectively, and 33 (16%) underwent a total of 51 ablation procedures to target 60 intra-atrial reentry tachycardias, 4 AV nodal reentry tachycardias and one atrial fibrillation (Figure 1). The primary outcome occurred in 21 patients (10%) and the secondary outcome in 18 (9%) (Figure 2). Primary and secondary outcomes were more common in patients with concomitant ventricular septum defect (VSD) than in those without (hazard ratio [HR] 3.06; 95% confidence interval [CI] 1.29-7.27, p=0.011; and HR 3.62; 95% CI 1.43-9.18, p=0.007, respectively).
Conclusions
At a median age of 35 years, arrhythmias occur in almost half of patients with d-TGA and atrial switch and associated rhythm interventions are frequent. One in ten patients does not survive free from LVAD and HTx and outcome is worse in patients with concomitant VSD.
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Affiliation(s)
- N Nozica
- Heart Center of Bern, Bern, Switzerland
| | | | - S Aur
- Lausanne University Hospital, Lausanne, Switzerland
| | - M Greutmann
- University Heart Center, Zurich, Switzerland
| | | | - J Bouchardy
- Lausanne University Hospital, Lausanne, Switzerland
| | - M Gass
- University Heart Center, Zurich, Switzerland
| | - F Duru
- University Heart Center, Zurich, Switzerland
| | - P Pascale
- Lausanne University Hospital, Lausanne, Switzerland
| | | | - E Pruvot
- Lausanne University Hospital, Lausanne, Switzerland
| | - T Wolber
- University Heart Center, Zurich, Switzerland
| | - L Roten
- Heart Center of Bern, Bern, Switzerland
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Abdurashidova T, Beishenkulov M, Zhorupbekova K, Chazymova Z, Kalysov K, Toktosunova A, Kaliev K, Tzimas G, Barras N, Aur S, Yerly P, Monney P, Kirsch M, Muller M, Hullin R. THE IMPACT OF HEART FAILURE ETIOLOGY AND PROGNOSTIC DISCHARGE TREATMENT ON ONE-YEAR ALL-CAUSE MORTALITY IN A CENTRAL ASIAN AND A WESTERN EUROPEAN ACUTE HEART FAILURE COHORT. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lu H, Roux O, Fournier S, Aur S, Hullin R, Antiochos P, Pucci L, Monney P, Schwitter J, Le Bloa M, Domenichini G, Pascale P, Pruvot E, Mahendiran T, Bouchardy J, Rutz T, Duchini M, Muller O. [Cardiology]. Rev Med Suisse 2022; 18:144-151. [PMID: 35107886 DOI: 10.53738/revmed.2022.18.767.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Significant advances have been made in 2021 in the areas of interventional cardiology, heart failure, cardiac imaging, electrophysiology and congenital heart disease. In addition to improving the screening, diagnosis and management of many heart diseases, these advances will change our daily practice. Moreover, the European Society of Cardiology has updated its guidelines on heart failure, valve disease, cardiac pacing and cardiovascular disease prevention. As in previous years, members of the Cardiology division of Lausanne University Hospital (CHUV) came together to select and present to you the papers that they considered to be the most important of the past year.
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Affiliation(s)
- Henri Lu
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Roux
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Stefania Aur
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Roger Hullin
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Lorenzo Pucci
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Patrizio Pascale
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Etienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Thabo Mahendiran
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mattia Duchini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
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Anouck Z, Tozzi P, Regamey J, Abdurashidova T, Meyer P, Lefol K, Pascual M, Yerly P, Aubert V, Aur S, Rancati V, Marcucci C, Rusca M, Rotman S, Pretre R, Kirsch M, Hullin R. Has the profile of heart transplantation recipients changed within the last three decades? Swiss Med Wkly 2022; 152:w30108. [PMID: 35072415 DOI: 10.4414/smw.2022.w30108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Heart transplantation remains the most durable treatment for patients with end-stage heart failure refractory to medical treatment. Central elements of the listing criteria for heart transplantation have remained largely unchanged in the last three decades whereas treatment of heart failure has significantly increased survival and reduced disease-related symptoms. It remains unknown whether the improvement of heart failure therapy changed the profile of heart transplantation candidates or affected post-transplant survival. METHODS The study investigated a total of 323 heart transplant recipients of the Lausanne University Hospital with 328 transplant operations between 1987 and 2018. Patients were separated into three groups on the basis of availability of heart failure therapy: period 1 (1987-1998; n = 115) when renin-angiotensin system blockade and diuretic treatment were available; period 2 (1999-2010; n = 106) marked by the addition of beta-blocker and mineralocorticoid receptor antagonist treatment in severe heart failure, and the establishment of cardiac defibrillator and resynchronisation therapy; period 3 (2011-2018; n = 107) characterised by the increasing use of ventricular assist devices for bridge to transplantation. RESULTS The patient characteristics age (all: 53.4 years), male sex (all: 79%) and body mass index (all: 24.5 kg/m2) did not differ between periods. History of arterial hypertension was less prevalent in period 2 (period 1 vs 2 vs 3: 44 vs 28 vs 43%, p = 0.04) whereas other cardiovascular risk factors were equally distributed. Left ventricular ejection fraction, VO2max, and pulmonary vascular resistance were not different between the three periods. The prevalence of ischaemic cardiomyopathy was higher in periods 1 and 3; dilated non-ischaemic cardiomyopathy was more frequent in period 2. Post-transplant 1-year survival was highest in period 3 (1 vs 2 vs 3: 87.2 ± 3.2% vs 70.8 ± 4.4% vs 93.0 ± 2.6%, p always ≤0.02), and the Kaplan-Meier estimates of survivors of the first year post-transplant were not different between the three periods. In descriptive analysis, early mortality was not associated with acknowledged pretransplant predictors of post-transplant mortality. CONCLUSION Availability of different medical heart failure treatments did not result in greatly different pretransplant characteristics of heart transplantation recipients across the three periods. This suggests that the maintained central criteria of listing for heart transplantation still identify end-stage heart failure patients with a similar profile. This finding can explain the unchanged overall mortality on condition of 1-year survival across the three periods, since pretransplant characteristics are relevant for long-term survival after heart transplantation.
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Affiliation(s)
- Zurbuchen Anouck
- Cardiology, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Piergiorgio Tozzi
- Cardiac surgery, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Julien Regamey
- Cardiology, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Tamila Abdurashidova
- Cardiology, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Philippe Meyer
- Cardiogy, Department of Medical Specialties, University Hospital Geneva, Switzerland
| | | | | | - Patrick Yerly
- Cardiology, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | | | - Stefania Aur
- Cardiology, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Valentina Rancati
- Anaesthesiology, Department of Abdominal Surgery and Anesthesiology, University Hospital Lausanne, University of Lausanne, Switzerland
| | - Carlo Marcucci
- Anaesthesiology, Department of Abdominal Surgery and Anesthesiology, University Hospital Lausanne, University of Lausanne, Switzerland
| | - Marco Rusca
- Department of Intensive Care, University Hospital Lausanne, University of Lausanne, Switzerland
| | - Sam Rotman
- Pathology, University Hospital Lausanne, University of Lausanne, Switzerland
| | - Rene Pretre
- Cardiac surgery, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Matthias Kirsch
- Cardiac surgery, Cardiovascular Department, University Hospital Lausanne, Switzerland
| | - Roger Hullin
- Cardiology, Cardiovascular Department, University Hospital Lausanne, Switzerland
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Yerly P, Rotman S, Regamey J, Aubert V, Aur S, Kirsch M, Hullin R, Pascual M. Complement blockade with eculizumab to treat acute symptomatic humoral rejection after heart transplantation. Xenotransplantation 2022; 29:e12726. [PMID: 35001433 PMCID: PMC9285545 DOI: 10.1111/xen.12726] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022]
Abstract
Antibody‐mediated rejection (AMR) is a major barrier preventing successful discordant organ xenotransplantation, but it also occurs in allotransplantation due to anti‐HLA antibodies. Symptomatic acute AMR is rare after heart allograft but carries a high risk of mortality, especially >1 year after transplant. As complement activation may play a major role in mediating tissue injury in acute AMR, drugs blocking the terminal complement cascade like eculizumab may be useful, particularly since “standards of care” like plasmapheresis are not based on strong evidence. Eculizumab was successfully used to treat early acute kidney AMR, a typical condition of “active AMR,” but showed mitigated results in late AMR, where “chronic active” lesions are more prevalent. Here, we report the case of a heart recipient who presented with acute heart failure due to late acute AMR with eight de novo donor‐specific anti‐HLA antibodies (DSA), and who fully recovered allograft function and completely cleared DSA following plasmapheresis‐free upfront eculizumab administration in addition to thymoglobulin, intravenous immunoglobulins (IVIG), and rituximab. Several clinical (acute onset, abrupt and severe loss of graft function), biological (sudden high‐level production of DSA), and pathological features (microvascular injury, C4d deposits) of this cardiac recipient are shared with early kidney AMR and may indicate a strong role of complement in the pathogenesis of acute graft injury that may respond to drugs like eculizumab. Terminal complement blockade should be further explored to treat acute AMR in recipients of heart allografts and possibly also in recipients of discordant xenografts in the future.
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Affiliation(s)
- Patrick Yerly
- Service of Cardiology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Samuel Rotman
- Service of Clinical Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Julien Regamey
- Service of Cardiology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Vincent Aubert
- Service of Immunology and Allergology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Stefania Aur
- Service of Cardiology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Matthias Kirsch
- Service of Cardiac Surgery, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Roger Hullin
- Service of Cardiology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Manuel Pascual
- Center for Organ Transplantation, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
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Hullin R, Regamey J, Yerly P, Aur S, Abdurashidova T, Rancati V, Tozzi P, Kirsch M. Advanced heart failure: when and what to consider for left ventricular assist device implantation? Cardiovasc Med 2021. [DOI: 10.4414/cvm.2021.02169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
| | - Julien Regamey
- Cardiologie, Département Coeur-Vaisseaux; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
| | - Patrick Yerly
- Cardiologie, Département Coeur-Vaisseaux; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
| | - Stefania Aur
- Cardiologie, Département Coeur-Vaisseaux; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
| | - Tamila Abdurashidova
- Cardiologie, Département Coeur-Vaisseaux; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
| | - Valentina Rancati
- Département Anesthésiologie; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
| | - Piergiorgio Tozzi
- Chirurgie Cardiaque, Département Coeur-Vaisseaux; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
| | - Matthias Kirsch
- Chirurgie Cardiaque, Département Coeur-Vaisseaux; Centre Hospitalier Universitaire Vaudois; Université de Lausanne
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Aur S, Rosset S, Monnier P, Stern A, Pellaton C. [Cardio-oncology : a specialty for the future]. Rev Med Suisse 2021; 17:434-441. [PMID: 33656296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cardio-oncology is a specialty that has rapidly progressed during the last decade. Modern cancer therapies have shown a significant positive impact on the survival of cancer patients. Alongside the progress in oncological treatments came a wide array of cardiac toxicities. The development of cardiotoxicity can lead to unfortunate outcomes. Ensuring the optimal oncological treatment while protecting the heart and vascular system constitute the main objectives of the cardio-oncology unit. Its purpose is to prevent, treat and provide adequate follow-up of patients subject to cardiotoxic drugs.
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Affiliation(s)
- Stefania Aur
- Service de cardiologie, Département de médecine, Réseau hospitalier neuchâtelois, 2000 Neuchâtel
- Service de cardiologie, CHUV, 1011 Lausanne
| | - Sabina Rosset
- Service de cardiologie, Département de médecine, Réseau hospitalier neuchâtelois, 2000 Neuchâtel
| | - Patrick Monnier
- Service de cardiologie, Département de médecine, Réseau hospitalier neuchâtelois, 2000 Neuchâtel
| | - Alix Stern
- Département d'hématologie et d'oncologie, Réseau hospitalier neuchâtelois, 2000 Neuchâtel
| | - Cyril Pellaton
- Service de cardiologie, Département de médecine, Réseau hospitalier neuchâtelois, 2000 Neuchâtel
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