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Quilty effect and its uncertain repercussion in heart transplated patients
Session:
Posters (Sessão 1 - Écran 5) - Doença Vascular e Cirurgia Cardíaca
Speaker:
Francisco Barbas de Albuquerque
Congress:
CPC 2022
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.8 Cardiovascular Surgery - Transplantation
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Francisco Barbas de Albuquerque; Ana Raquel Carvalho Santos; António Valentim Gonçalves; Rita Ilhão Moreira; Tiago Pereira-Da-Silva; Valdemar Gomes; Rui Soares; Lídia de Sousa; Rui Cruz Ferreira
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Background</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Endomyocardial biopsy (EBM) remains the gold-standard technique to assess acute cellular rejection (ACR) in heart transplant (HT) patients. Quilty effect (QE) is a nodular lymphoid subendocardial inflammatory infiltrate occasionally seen histologically in EMB. Its clinical significance, regarding ACR and poor analytical, transthoracic echocardiographic (TTE), and right-heart catheterization (RHC) hemodynamic parameters is still not well stablished.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Aim</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">To assess whether presence of QE on EMB was associated with analytical, TTE and RHC hemodynamic parameter values differences, compared to the group without QE on EMB.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Retrospective analysis of consecutive HT patients submitted to EMB between February 2016 and November 2021, who performed at the same day blood analysis, TTE and RHC. EMB histology reports were peer reviewed for the presence of QE to compare groups. Mean comparison of analytical, TTE and RHC parameter values was performed by independent sample T-Test with <em>p</em> value < 0.05 for clinical significance (SPSS®)</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A total of 127 EMB were performed during the study period. Of these, 11 (8.6%) had QE on EMB histology and 117 (91.3%) did not have QE. 2 patients had both QE and ACR (defined as ≥ 2R grading on EMB) and 9 had QE without ACR (defined as 0 or 1R grading on EMB). </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Mean age was 49.5 years, mean left ventricular ejection fraction was 57.7 ± 10.2%, BNP 808 ± 984pg/mL and NT-pro BNP 4221 ± 8418pg/mL. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Analytical, TTE and RHC hemodynamic parameters mean values comparison between groups is illustrated on Table 1. The presence of Quilty effect was not significantly associated with any TTE parameters value between the two studied groups. RHC hemodynamic values also did not proved to be significantly different between groups. NT-proBNP was the only analytical parameter to be significantly increased in QE group.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion</span></span></p> <p><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">The role of presence of QE in HT patient clinical status, as well as its repercussion on analytical, TTE and RHC hemodynamic values is still challenging and controversial. This study showed the presence of QE was not associated with differences in analytical, TTE and RHC hemodynamic values between patients with and without QE. Also, only a small percentage of patients had both ACR and QE on EMB. In this study population QE appeared to be a benign situation, not associated with any particular outcome, compared to patients who did not have this finding on EMB.</span></span></p>
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