Heart Failure, Heart Transplantation
Conditions
Keywords
Pericoronary adipose tissue, adipocyte size, inflammatory changes, macrophages
Brief summary
Evaluation of pericoronary adipocyte gradient (PCAT) in relationship with local atherosclerotic changes in a patient undergoing heart transplantation.
Detailed description
The project is designed to analyze the impact of inflammation spreading from pericoro-nary adipose tissue to the arterial wall or vice versa. Adipocyte size and immunometabolic parameters gradients established from independent analysis of samples closely adjacent to the coronary artery and those more distant from the arterial lumen will be used to establish the direction of inflammation propagation. The coronary arteries, along with adjacent pericoronary adipose tissue, from explanted hearts will be obtained during heart transplantation of patients with advanced atherosclerosis (ischemic heart disease) and with less advanced atherosclerotic disease (dilated cardiomyopathy). Clinical data (including age, BMI, comorbidities, and concomitant medications) will be recorded. Specifically, previous left ventricular assist device (LVAD) implantation, used as a bridge-to-transplant approach, will be followed to establish the effect of artificial hemodynamic disturbance on coronary artery blood flow on study endpoints.
Interventions
PROCEDUREHeart transplantation for the final stage of heart failure
The study population comprises patients who underwent heart transplantation for heart failure at the Institute for Clinical and Experimental Medicine, Cardiovascular Surgery Department, between June 2023 and December 2028. Only the subjects' retrospective clinical data and matching heart samples will be analyzed.
Sponsors
Institute for Clinical and Experimental Medicine
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
30 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Age 30-90 years * Diagnosis of dilatational or ischemic cardiomyopathy * Patients undergoing heart transplantation in IKEM
Exclusion criteria
* Known combined diagnosis of dilatational and ischemic cardiomyopathy * Arrhythmogenic cardiomyopathy * Congenital heart defects * Non-eligibility due to the absence of informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adipocyte size | Perioperative/Periprocedural | Assessment of the difference (in square micrometer) between adipocyte size closely adjacent to the coronary artery and those more distant from the arterial lumen in relation to atherosclerotic pathologies in situ |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immunological parameters | Perioperative/Periprocedural | The immunological characteristics-T cells (counts and percentages), B cells (counts and percentages), macrophages and their subpopulations (counts and percentages)-and the immunohistochemical biomarkers sclerostin, TREM-2 (triggering receptor expressed on myeloid cells 2), and mimecan (score) in the arterial wall and pericoronary adipose tissue (PCAT) will be analyzed and compared. |
| Morphological parameters | Perioperative/Periprocedural | The morphological characteristics-atherosclerotic plaque type (category) and calcification rate (percentage)-in the arterial wall and pericoronary adipose tissue (PCAT) will be analyzed and compared. |
Countries
Czechia
Contacts
CONTACTIvana K Lesna, MD, PhD., assoc. prof.
CONTACTPeter Ivak, M.D., PhD, assoc. prof.
Outcome results
None listed