Cardiac allograft vasculopathy (CAV), the major limitation to long term survival after heart transplantation, occurs when blood vessels in a transplanted heart progressively narrow and lead to dysfunction of the heart muscle or sudden death.
Ascertaining benefit from appropriate treatment for this condition has been hampered in part because of the lack of a standard nomenclature. In an article published online today in The Journal of Heart and Lung Transplantation (www.jhltonline.org), clinicians representing the International Society for Heart and Lung Transplantation (ISHLT) Working Group on Classification of Cardiac Allograft Vasculopathy issued the first international consensus formulation of a standardized nomenclature for CAV.
"The development of cardiac allograft vasculopathy remains the Achilles heel of cardiac transplantation," commented working group leader, Mandeep R. Mehra, MD, Herbert Berger Professor and Head of Cardiology, University of Maryland School of Medicine, Baltimore, MD. "Unfortunately, the definitions of cardiac allograft vasculopathy are diverse and confusion abounds. There have been no uniform international standards for the nomenclature of this entity. The lack of a standard language has led to confusion in the interpretation of various studies and several unanswered questions persist. The ISHLT consensus statement is the first step in resolving these issues and improving cardiac transplant patient outcomes."
This consensus document, commissioned by the International Society for Heart and Lung Transplantation Board, is based on best evidence and clinical consensus derived from critical analysis of available information pertaining to angiography, intravascular ultrasound imaging, microvascular function, cardiac allograft histology, circulating immune markers, noninvasive imaging tests, and gene-based and protein-based biomarkers.
ISHLT President, John Dark, FRCS, stated, "The consensus document from the international working group led by Dr. Mehra defines the descriptors of the major clinical challenge late after cardiac transplantation. It also defines the ISHLT as the organization unifying all those, scientists and clinicians, working in this field, and able to put the stamp of authority on the recommendations. The topic is rapidly evolving, but Dr Mehra and his colleagues have undertaken to keep the data under close review. We can anticipate further definitive analyses in the future."
This article presents 5 consensus statements that describe how to best identify CAV and assess its severity. By developing a standard nomenclature, appropriate treatment options can be selected, depending on the level of CAV. Four levels of CAV are defined, ranging from CAV0 (not significant), where no angiographic lesions are detected, to CAV3 (severe), where multiple major heart vessels are involved. Key among the recommendations to define the severity of CAV is to view the anatomy of the allograft vasculature in concert with the physiological effects of the disease on cardiac allograft function.
The article is "International Society for Heart and Lung Transplantation working formulation of a standardized nomenclature for cardiac allograft vasculopathy—2010" by Mandeep R. Mehra, MD, Maria G. Crespo-Leiro, MD, Anne Dipchand, MD, Stephan M. Ensminger, MD, PhD, Nicola E. Hiemann, MD, Jon A. Kobashigawa, MD, Joren Madsen, MD, PhD, Jayan Parameshwar, MD, Randall C. Starling, MD, MPH, and Patricia A. Uber, BS, PharmD. doi: 10.1016/j.healun.2010.05.017. The article appears in The Journal of Heart and Lung Transplantation, Volume 29, Issue 7 (July 2010), p 717-727, published by Elsevier. The article is freely available at www.jhltonline.org.
Study tracks inner workings of the brain with new biosensor
16.08.2018 | Rheinische Friedrich-Wilhelms-Universität Bonn
Foods of the future
15.08.2018 | Georg-August-Universität Göttingen
There are currently great hopes for solid-state batteries. They contain no liquid parts that could leak or catch fire. For this reason, they do not require cooling and are considered to be much safer, more reliable, and longer lasting than traditional lithium-ion batteries. Jülich scientists have now introduced a new concept that allows currents up to ten times greater during charging and discharging than previously described in the literature. The improvement was achieved by a “clever” choice of materials with a focus on consistently good compatibility. All components were made from phosphate compounds, which are well matched both chemically and mechanically.
The low current is considered one of the biggest hurdles in the development of solid-state batteries. It is the reason why the batteries take a relatively long...
New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference
Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...
Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
17.08.2018 | Event News
08.08.2018 | Event News
27.07.2018 | Event News
20.08.2018 | Information Technology
20.08.2018 | Life Sciences
20.08.2018 | Information Technology