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Endothelial dysfunction and cytomegalovirus replication in pediatric heart transplantation

Simmonds, Jacob, Fenton, Matthew, Dewar, Catherine, Ellins, Elizabeth Anne ORCID:, Storry, Clare, Cubitt, David, Deanfield, John, Klein, Nigel, Halcox, Julian P. J. and Burch, Michael 2008. Endothelial dysfunction and cytomegalovirus replication in pediatric heart transplantation. Circulation 117 (20) , pp. 2657-2661. 10.1161/CIRCULATIONAHA.107.718874

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Background— Cardiac allograft vasculopathy is the major limiting factor to the long-term success of pediatric heart transplantation. Cytomegalovirus (CMV) has been shown to be a significant risk factor for the development of cardiac allograft vasculopathy. Recent work has demonstrated CMV DNA in leukocytes in the absence of direct allograft infection, suggesting that vascular changes may not be limited to the allograft. Method and Results— Systemic arterial endothelial function was assessed with high-resolution ultrasound to determine brachial artery flow-mediated dilation in 50 pediatric heart transplant recipients (8 to 17 years of age; 27 male). Patients were separated into 2 groups according to CMV status: those without evidence of CMV replication after transplantation (n=38; 19 male) and patients with evidence of viremia after transplantation (n=12; 8 male). No patient had detectable viremia at the time of study. Flow-mediated dilation was significantly impaired in patients with evidence of CMV replication after transplantation (6.64±1.12%, mean±SE) compared with those without (9.48±0.56%; P=0.02). This difference remained after adjustment for age, time since transplantation, and medication. Pretransplantation recipient and donor CMV status and traditional CMV risk were not associated with flow-mediated dilation. Conclusions— CMV replication after cardiac transplantation is associated with chronic endothelial dysfunction in the systemic circulation in children. The implication for both systemic and coronary vascular health requires prospective evaluation.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: Q Science > QR Microbiology > QR355 Virology
R Medicine > RD Surgery
R Medicine > RJ Pediatrics
Uncontrolled Keywords: endothelium; pediatrics; transplantation; virus
Additional Information: Pdf uploaded in accordance with publisher's policy at (accessed 19/02/2014).
Publisher: American Heart Association
ISSN: 0009-7322
Date of First Compliant Deposit: 30 March 2016
Last Modified: 21 May 2023 12:37

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