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Donor Myocardial HIF‐1α Is an Independent Predictor of Cardiac Allograft Dysfunction: A 7‐Year Prospective, Exploratory Study
Author(s) -
Aharinejad S.,
Schäfer R.,
Krenn K.,
Zuckermann A.,
Schneider B.,
Neumann F.,
Paulus P.,
Wieselthaler G.,
Wolner E.,
Grimm M.
Publication year - 2007
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2007.01875.x
Subject(s) - medicine , logistic regression , cardiology , receiver operating characteristic , prospective cohort study , transplantation , univariate analysis , multivariate analysis
Knowledge on interplay between the cardiac molecular response to transplantation‐induced stress and primary graft dysfunction (PGD) is limited. A cDNA array identified HIF‐1, EGR‐1, NAB‐2, VEGF‐A and uPA as mediators of cardiac tissue response to transplantation‐induced stress. mRNA expression of these molecules was measured in left ventricular biopsies from 200 donors before and after aortic cross‐clamping and at 10‐, 30‐ and 60‐min reperfusion by real‐time RT‐PCR. HIF‐1α expression at two time points was significantly associated with PGD, as shown by univariate analysis, receiver operating characteristic curve and multivariate logistic regression. At a cut‐off level of 200 arbitrary units, HIF‐1α after aortic cross‐clamping in donors (78% sensitivity, 83% specificity) and at 10‐min reperfusion (85% sensitivity, 83% specificity) identified PGD. HIF‐1α demonstrates the potential to be a predictive marker for PGD; however, as multiple factors were tested at different time points, prospective evaluation is clearly necessary to confirm this observation.