{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:32:34Z","timestamp":1790058754621,"version":"4.0.1"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T00:00:00Z","timestamp":1499731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007405","name":"Hjerteforeningen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>We examined the relationship between donor\u2010specific HLA antibody (DSA) presence and graft function, hemodynamics, cardiac allograft vasculopathy (CAV), and major adverse cardiac events (MACE) in stable long\u2010term heart\u2010transplanted (HTx) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sera from 79 patients (median 7.5\u00a0years after HTx) were analyzed for DSA presence. Graft function was evaluated by echocardiography and right heart catheterization. CAV burden was determined by coronary angiography, optical coherence tomography (OCT), and coronary flow velocity reserve (CFVR). Patients were prospectively followed after DSA assessment. MACE included significant CAV progression, heart failure, treated rejection, and cardiovascular death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients had no DSA, and 19 patients were sensitized. The vasculopathy burden by angiography, OCT, and CFVR was more pronounced in DSA\u2010positive patients than in DSA\u2010negative patients. DSA\u2010positive patients had higher pulmonary capillary wedge pressure (16 [8; 21] vs 9\u00a0mm\u00a0Hg [7; 11],<jats:italic>P<\/jats:italic>&lt;.05) and right atrial pressure (8 [6; 9] vs 4\u00a0mm\u00a0Hg [2; 6],<jats:italic>P<\/jats:italic>&lt;.01) and lower global longitudinal strain (\u221213% [\u221210; \u221215] vs \u221216% [\u221214; \u221217],<jats:italic>P<\/jats:italic>&lt;.01) than DSA\u2010negative patients.<\/jats:p><jats:p>DSA presence was a strong MACE predictor (HR 4.7 (95% CI 2.0\u201011.4),<jats:italic>P<\/jats:italic>&lt;.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DSA\u2010positive patients had higher vasculopathy burden, higher filling pressures, and lower longitudinal myocardial deformation than DSA\u2010negative patients. The DSA presence was a strong MACE predictor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13033","type":"journal-article","created":{"date-parts":[[2017,6,19]],"date-time":"2017-06-19T05:06:40Z","timestamp":1497848800000},"source":"Crossref","is-referenced-by-count":23,"title":["Donor\u2010specific antibodies are associated with micro\u2010 and macrovascular coronary disease, restrictive myocardial damage, and poor outcome in heart\u2010transplanted patients"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-6404","authenticated-orcid":false,"given":"Tor Skibsted","family":"Clemmensen","sequence":"first","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Skejby Denmark"},{"name":"Department of Cardiology Horsens Regional Hospital Horsens Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernille","family":"Koefoed\u2010Nielsen","sequence":"additional","affiliation":[{"name":"Department of Clinical 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H\u00f8j","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Skejby Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jouke","family":"Dijkstra","sequence":"additional","affiliation":[{"name":"Division of Image Processing Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamilla Pernille Bjerre","family":"Valen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Skejby Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Eiskj\u00e6r","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Skejby 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