scholarly journals Detection of acute rejection: validation of non-invasive diagnostic tests

1997 ◽  
Vol 18 (6) ◽  
pp. 885-886 ◽  
Author(s):  
M. BALLESTER
Keyword(s):  
Acute Rejection ◽  
Diagnostic Tests ◽  
Non Invasive

The most useful and commonly available acute rejection surveillance strategies are routine monitoring of myocardial function and donor-specific anti-HLA Abs monitoring

2021 ◽  
Author(s):  
Moataz Dowaidar
Keyword(s):  
Acute Rejection ◽  
Cell Function ◽  
Clinical Symptoms ◽  
Contractile Function ◽  
Therapy Monitoring ◽  
Genomic Medicine ◽  
Non Invasive ◽  
Monitoring Tools ◽  
Immune Mediated ◽  
Routine Monitoring

Given the complexity of acute rejection (AR) pathogenesis and its vast spectrum of clinical symptoms, no methodology (invasive or non-invasive) can provide all the information needed to identify functionally and prognostically relevant AR, treatment selection, and therapy monitoring early. Only the use of EMBs in combination with non-invasive technologies and methods to detect subclinical changes in myocardial contractile function (e.g., TDI and STE), to detect alloimmune activation (e.g., IM assay, assessment of complement-activating donor-specific anti-HLA Abs (DSAbs), screening of circulating cfdDNA), and to predict the imminent risk of immune-mediated injury (e.g., assessment of complement-activating DSAbs).Searching for both ACR and AMR in all EMBs is a key prerequisite for accurate diagnosis and decision-making in individuals suspected of AR. Close non-invasive allograft surveillance to detect patients at high risk of AR, along with properly planned EMBs (depending on the particular risk profile of the patient), can improve AR surveillance while decreasing rsEMBs. Because rsEMBs are less prevalent after the first post-HTx year and largely symptom-driven diagnostic EMBs, ongoing development of comprehensive, non-invasive technology to monitor both ACR and AMR is of significant importance. This is especially helpful for detecting late subclinical AMR, which would otherwise go unreported.The most useful and commonly available AR surveillance strategies are routine monitoring of myocardial functions utilizing sensitive ECHO techniques (TDI and STE for acute subclinical dysfunction diagnosis) and DSAb monitoring. As a result, early and late use of HTx is strongly suggested. New IM technologies such as T-cell function assays and genomic medicine approaches such as GEP, circulating dd-cfdDNA screening and microRNA assessment are promising non-invasive monitoring tools for future clinical use, but it is still necessary to test the practical value of their individual or combined use for AR detection (including both ACR and AMR), not just for ACR.

Lymphopaenia as a predictor of sarcoidosis in patients with a first episode of uveitis

2018 ◽  
Vol 103 (9) ◽  
pp. 1296-1300 ◽  
Author(s):  
Fahriye Groen-Hakan ◽  
Laura Eurelings ◽  
Aniki Rothova ◽  
Jan van Laar
Keyword(s):  
Diagnostic Tests ◽  
Medical Center ◽  
Age At Onset ◽  
Diagnostic Value ◽  
Youden Index ◽  
First Episode ◽  
Operating Characteristics ◽  
Non Invasive ◽  
Erasmus Medical ◽  
Uveitis Attack

Background/aimsThe diagnostic properties of conventional diagnostic tests (ACE and chest radiography) for sarcoidosis-associated uveitis are not ideal. The diagnostic value of lymphopaenia for sarcoidosis-associated uveitis is investigated.MethodsA retrospective study of 191 consecutive patients with a first uveitis episode visiting the ophthalmology department (Erasmus Medical Center, Rotterdam, The Netherlands). Receiver operating characteristics (ROC) analysis was performed and compared with known ROC values from literature of conventional diagnostic tests for sarcoidosis-associated uveitis. An ideal cut-off was determined for lymphopaenia by calculation of the highest Youden index.ResultsOut of all patients with first uveitis attack, 32/191 or 17% were subsequently diagnosed with biopsy-proven or radiological diagnosis of sarcoidosis. Lymphopaenia (<1.5×109/L) was significantly more often observed in patients with sarcoidosis-associated uveitis compared with patients with non-sarcoidosis-associated uveitis (p<0.05). The sensitivity and specificity of lymphopaenia was 75 % and 77 %, respectively. The optimal cut-off for lymphopaenia for diagnosing sarcoidosis-associated uveitis was 1.47 ×109/L. Lymphopaenia resulted in a 12.0 (95% CI 4.7 to 30.5 fold risk for having sarcoidosis, corrected for sex, race and age at onset of uveitis in patients with a first uveitis attack.ConclusionLymphopaenia is a non-invasive and useful marker for diagnosing sarcoidosis-associated uveitis.

scholarly journals Non-invasive electrophysiological imaging of acute rejection in a transplanted heart

EP Europace ◽  
2013 ◽  
Vol 15 (11) ◽  
pp. 1614-1614 ◽  
Author(s):  
K. A. Desouza ◽  
S. M. Joseph ◽  
Y. Rudy
Keyword(s):  
Acute Rejection ◽  
Non Invasive

PERSONIFIED MONITORING OF ACUTE CORONARY SYNDROME AND ITS OUTCOMES IN ELDERLY PATIENTS. ANGINA. HEART FAILURE (OVERVIEW)

2020 ◽  
pp. 92-98
Author(s):  
А. С. Пушкин
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Diagnostic Tests ◽  
Diagnostic Process ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Patients With Heart Failure

В обзорной статье собраны современные представления об особенностях диагностики и мониторинга пациентов пожилого и старческого возраста с сердечной недостаточностью и стенокардией. Особое внимание уделено проблеме коморбидности пациентов старше 65 лет, что требует корректирующих действий при стратификации риска и прогнозировании клинических исходов. Отмечена приоритетность неинвазивных диагностических тестов. Рекомендована оценка хрупкости как неотъемлемой части диагностического процесса пациентов с сердечной недостаточностью и стенокардией ввиду чёткой связи с худшим прогнозом с точки зрения качества жизни, госпитализации и смертности. Review is about current information on the features of heart failure and angina diagnosis and monitoring in elderly and senile patients. One of the main problem in patients over 65 years is comorbidity, which requires corrective action in the risk stratification and prediction of clinical outcomes. The priority of non-invasive diagnostic tests is noted. Authors of the article recommend frailty as an obligatory part of diagnostic process in patients with heart failure and angina due to a clear connection with the worst prognosis in terms of quality of life, hospitalization and mortality.

scholarly journals Challenges in Using Circulating Micro-RNAs as Biomarkers for Cardiovascular Diseases

2020 ◽  
Vol 21 (2) ◽  
pp. 561 ◽  
Author(s):  
Kyriacos Felekkis ◽  
Christos Papaneophytou
Keyword(s):  
Cardiovascular Diseases ◽  
Diagnostic Tests ◽  
Future Research ◽  
Circulating Mirnas ◽  
Significant Progress ◽  
Factors Affecting ◽  
Non Invasive ◽  
Micro Rnas ◽  
Specific Amplification ◽  
Disease Specific

Micro-RNAs (miRNAs) play a pivotal role in the development and physiology of the cardiovascular system while they have been associated with multiple cardiovascular diseases (CVDs). Several cardiac miRNAs are detectable in circulation (circulating miRNAs; c-miRNAs) and are emerging as diagnostic and therapeutic biomarkers for CVDs. c-miRNAs exhibit numerous essential characteristics of biomarkers while they are extremely stable in circulation, their expression is tissue-/disease-specific, and they can be easily detected using sequence-specific amplification methods. These features of c-miRNAs are helpful in the development of non-invasive assays to monitor the progress of CVDs. Despite significant progress in the detection of c-miRNAs in serum and plasma, there are many contradictory publications on the alterations of cardiac c-miRNAs concentration in circulation. The aim of this review is to examine the pre-analytical and analytical factors affecting the quantification of c-miRNAs and provide general guidelines to increase the accuracy of the diagnostic tests in order to improve future research on cardiac c-miRNAs.

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