(1) Background: survivors of allogeneic hematopoietic cell transplantation (alloHCT) suffer from morbidity and mortality due to cardiovascular events. We hypothesized that vascular injury and pro-coagulant activity are evident in alloHCT survivors without existing alloHCT complications or relapse. (2) Methods: we enrolled consecutive adult alloHCT survivors without established cardiovascular disease and control individuals matched for traditional cardiovascular risk factors (January-December 2019). Circulating microvesicles (MVs) of different cellular origins (platelet, erythrocyte, and endothelial) were measured by a standardized flow cytometry protocol as novel markers of vascular injury and pro-coagulant activity. (3) Results: we recruited 45 survivors after a median of 2.3 (range 1.1-13.2) years from alloHCT, and 45 controls. The majority of patients suffered from acute (44%) and/or chronic (66%) graft-versus-host disease (GVHD). Although the two groups were matched for traditional cardiovascular risk factors, alloHCT survivors showed significantly increased platelet and erythrocyte MVs compared to controls. Within alloHCT survivors, erythrocyte MVs were significantly increased in patients with a previous history of thrombotic microangiopathy. Interestingly, endothelial MVs were significantly increased only in alloHCT recipients of a myeloablative conditioning. Furthermore, MVs of different origins showed a positive association with each other. (4) Conclusions: endothelial dysfunction and increased thrombotic risk are evident in alloHCT recipients long after alloHCT, independently of traditional cardiovascular risk factors. An apparent synergism of these pathophysiological processes may be strongly involved in the subsequent establishment of cardiovascular disease.
(1) Background: survivors of allogeneic hematopoietic cell transplantation (alloHCT) suffer from morbidity and mortality due to cardiovascular events. We hypothesized that vascular injury and pro-coagulant activity are evident in alloHCT survivors without existing alloHCT complications or relapse. (2) Methods: we enrolled consecutive adult alloHCT survivors without established cardiovascular disease and control individuals matched for traditional cardiovascular risk factors (January-December 2019). Circulating microvesicles (MVs) of different cellular origins (platelet, erythrocyte, and endothelial) were measured by a standardized flow cytometry protocol as novel markers of vascular injury and pro-coagulant activity. (3) Results: we recruited 45 survivors after a median of 2.3 (range 1.1-13.2) years from alloHCT, and 45 controls. The majority of patients suffered from acute (44%) and/or chronic (66%) graft-versus-host disease (GVHD). Although the two groups were matched for traditional cardiovascular risk factors, alloHCT survivors showed significantly increased platelet and erythrocyte MVs compared to controls. Within alloHCT survivors, erythrocyte MVs were significantly increased in patients with a previous history of thrombotic microangiopathy. Interestingly, endothelial MVs were significantly increased only in alloHCT recipients of a myeloablative conditioning. Furthermore, MVs of different origins showed a positive association with each other. (4) Conclusions: endothelial dysfunction and increased thrombotic risk are evident in alloHCT recipients long after alloHCT, independently of traditional cardiovascular risk factors. An apparent synergism of these pathophysiological processes may be strongly involved in the subsequent establishment of cardiovascular disease.
Authors: Bryan Williams; Giuseppe Mancia; Wilko Spiering; Enrico Agabiti Rosei; Michel Azizi; Michel Burnier; Denis L Clement; Antonio Coca; Giovanni de Simone; Anna Dominiczak; Thomas Kahan; Felix Mahfoud; Josep Redon; Luis Ruilope; Alberto Zanchetti; Mary Kerins; Sverre E Kjeldsen; Reinhold Kreutz; Stephane Laurent; Gregory Y H Lip; Richard McManus; Krzysztof Narkiewicz; Frank Ruschitzka; Roland E Schmieder; Evgeny Shlyakhto; Costas Tsioufis; Victor Aboyans; Ileana Desormais Journal: Eur Heart J Date: 2018-09-01 Impact factor: 29.983
Authors: Geoffrey D E Cuvelier; Michelle Schoettler; Nataliya P Buxbaum; Iago Pinal-Fernandez; Marc Schmalzing; Jörg H W Distler; Olaf Penack; Bianca D Santomasso; Robert Zeiser; Klemens Angstwurm; Kelli P A MacDonald; W Taylor Kimberly; Naomi Taylor; Ervina Bilic; Bernhard Banas; Maike Buettner-Herold; Namita Sinha; Hildegard T Greinix; Joseph Pidala; Kirk R Schultz; Kirsten M Williams; Yoshihiro Inamoto; Corey Cutler; Linda M Griffith; Stephanie J Lee; Stefanie Sarantopoulos; Steven Z Pavletic; Daniel Wolff Journal: Transplant Cell Ther Date: 2022-05-31