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Journal article 1134 views

Endothelial dysfunction and Cytomegalovirus

Julian Halcox Orcid Logo, Libby Ellins Orcid Logo

Circulation, Volume: 117, Pages: 2657 - 2661

Swansea University Authors: Julian Halcox Orcid Logo, Libby Ellins Orcid Logo

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Abstract

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 leuk...

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Published in: Circulation
ISSN: 0009-7322
Published: 2008
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URI: https://cronfa.swan.ac.uk/Record/cronfa16044
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first_indexed 2013-09-26T11:45:54Z
last_indexed 2018-02-09T04:48:27Z
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2013-11-08T10:48:57.7882902</datestamp><bib-version>v2</bib-version><id>16044</id><entry>2013-09-18</entry><title>Endothelial dysfunction and Cytomegalovirus</title><swanseaauthors><author><sid>3676f695eeda169d0f8c618adf27c04b</sid><ORCID>0000-0001-6926-2947</ORCID><firstname>Julian</firstname><surname>Halcox</surname><name>Julian Halcox</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>553ce2abe05a6396e7dd6eadb6b90a6d</sid><ORCID>0000-0001-5164-6416</ORCID><firstname>Libby</firstname><surname>Ellins</surname><name>Libby Ellins</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2013-09-18</date><deptcode>HDAT</deptcode><abstract>Background&#x2014;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&#x2014;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 (n38; 19 male) and patients with evidence of viremia after transplantation (n12; 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 (6.641.12%, meanSE) compared with those without (9.480.56%; P0.02). 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&#x2014;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.</abstract><type>Journal Article</type><journal>Circulation</journal><volume>117</volume><paginationStart>2657</paginationStart><paginationEnd>2661</paginationEnd><publisher/><issnPrint>0009-7322</issnPrint><issnElectronic/><keywords>endothelium, pediatrics, transplantation, virus</keywords><publishedDay>31</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2008</publishedYear><publishedDate>2008-05-31</publishedDate><doi>10.1161/CIRCULATIONAHA.107.718874</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2013-11-08T10:48:57.7882902</lastEdited><Created>2013-09-18T12:30:13.4781253</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Julian</firstname><surname>Halcox</surname><orcid>0000-0001-6926-2947</orcid><order>1</order></author><author><firstname>Libby</firstname><surname>Ellins</surname><orcid>0000-0001-5164-6416</orcid><order>2</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2013-11-08T10:48:57.7882902 v2 16044 2013-09-18 Endothelial dysfunction and Cytomegalovirus 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false 553ce2abe05a6396e7dd6eadb6b90a6d 0000-0001-5164-6416 Libby Ellins Libby Ellins true false 2013-09-18 HDAT 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 (n38; 19 male) and patients with evidence of viremia after transplantation (n12; 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 (6.641.12%, meanSE) compared with those without (9.480.56%; P0.02). 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. Journal Article Circulation 117 2657 2661 0009-7322 endothelium, pediatrics, transplantation, virus 31 5 2008 2008-05-31 10.1161/CIRCULATIONAHA.107.718874 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2013-11-08T10:48:57.7882902 2013-09-18T12:30:13.4781253 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Julian Halcox 0000-0001-6926-2947 1 Libby Ellins 0000-0001-5164-6416 2
title Endothelial dysfunction and Cytomegalovirus
spellingShingle Endothelial dysfunction and Cytomegalovirus
Julian Halcox
Libby Ellins
title_short Endothelial dysfunction and Cytomegalovirus
title_full Endothelial dysfunction and Cytomegalovirus
title_fullStr Endothelial dysfunction and Cytomegalovirus
title_full_unstemmed Endothelial dysfunction and Cytomegalovirus
title_sort Endothelial dysfunction and Cytomegalovirus
author_id_str_mv 3676f695eeda169d0f8c618adf27c04b
553ce2abe05a6396e7dd6eadb6b90a6d
author_id_fullname_str_mv 3676f695eeda169d0f8c618adf27c04b_***_Julian Halcox
553ce2abe05a6396e7dd6eadb6b90a6d_***_Libby Ellins
author Julian Halcox
Libby Ellins
author2 Julian Halcox
Libby Ellins
format Journal article
container_title Circulation
container_volume 117
container_start_page 2657
publishDate 2008
institution Swansea University
issn 0009-7322
doi_str_mv 10.1161/CIRCULATIONAHA.107.718874
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description 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 (n38; 19 male) and patients with evidence of viremia after transplantation (n12; 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 (6.641.12%, meanSE) compared with those without (9.480.56%; P0.02). 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.
published_date 2008-05-31T03:18:19Z
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