Evidence map›Paper›PMID 37415291›Full record

ArticleESC heart failure2023

Heart transplantation and anti-HLA antibodY: myocardial dysfunction and prognosis - HeartLAy study.

Carlotta Sciaccaluga, Benedetta Maria Natali, Francesca Maria Righini, Carlotta Sorini Dini, Federico Landra, Giulia Elena Mandoli, Nicolò Sisti, Daniele Menci, Antonio D'Errico, Flavio D'Ascenzi and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Carlotta SciaccalugaDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.ORCID 0000-0002-1965-1773
Benedetta Maria NataliDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Francesca Maria RighiniDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Carlotta Sorini DiniDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Federico LandraDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Giulia Elena MandoliDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Nicolò SistiDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Daniele MenciDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Antonio D'ErricoDepartment of Internal Medicine, University of Siena, Siena, Italy.
Flavio D'AscenziDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Marta FocardiDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Sonia BernazzaliDepartment of Cardiac Surgery, University of Siena, Siena, Italy.
Massimo MaccheriniDepartment of Cardiac Surgery, University of Siena, Siena, Italy.
Serafina ValenteDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Matteo CameliDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
University of Siena · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe presence of anti-human leucocyte antigen (HLA) antibodies has been implicated in a higher incidence of complications as well as mortality rate in heart transplantation. The aim of the study was to identify through non-invasive parameters early signs of myocardial dysfunction in the presence of anti-HLA antibodies but without evidence of antibody-mediated rejection (AMR) and its possible prognostic impact. METHODS AND

resultsA total of 113 heart-transplanted patients without acute cellular rejection (ACR) and AMR or cardiac allograft vasculopathy (CAV) were prospectively enrolled and divided into two groups ['HLA+' (50 patients) and 'HLA-' (63 patients)], based on the presence of anti-HLA antibodies. Each patient was followed for 2 years after the enrolment, recording episodes of AMR, ACR, CAV, and mortality. Clinical characteristics were similar between the two groups. Among laboratory data, N-terminal pro-B-type natriuretic peptide and high-sensitivity cardiac troponin values were significantly higher in the presence of anti-HLA antibodies (P < 0.001 and P = 0.003, respectively). The echocardiographic parameters that showed a statistically significant difference between the two groups were deceleration time of E wave (DecT E, P < 0.001), left ventricular global longitudinal strain (P < 0.001), tricuspid annular plane systolic excursion (P = 0.011), tricuspid S' wave (P = 0.002), and free wall right ventricular longitudinal strain (fwRVLS, P = 0.027), whereas left atrial strain did not differ significantly (P = 0.408). Univariate analysis showed that anti-HLA antibodies were associated with the development of CAV at both 1 and 2 year follow-up [odds ratio (OR) 11.90, 95% confidence interval (CI) 1.43-90.79, P = 0.022 and OR 3.37, 95% CI 1.78-9.67, P = 0.024, respectively]. Bivariate analysis demonstrated that both fwRVLS and DecT E were predictors of CAV development independently from HLA status.

conclusionsThe 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.

Indexed as

Heart TransplantationAntibodiesEchocardiographyGraft RejectionHumansPrognosisAntibodiesAntibody-mediated rejectionAnti-HLA antibodyHeart transplantationPrognosis

Identifiers

PMID37415291
PMCPMC10567642
OpenAlexW4383482485

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.