Key result
The development of a restrictive left ventricular filling pattern 5 years after heart transplantation was associated with a persistent immune-related transcriptome signature, including allograft rejection pathways, despite no histological evidence of rejection.
Why the study?
Diastolic dysfunction is a chronic allograft complication linked to adverse outcomes, but the underlying pathophysiological mechanisms of restrictive left ventricular filling patterns remain unclear.
Cohort (n=32)
No
The development of a restrictive left ventricular filling pattern after heart transplantation is associated with a persistent immune-related transcriptome signature, suggesting subclinical immune activation despite no histological evidence of rejection.
Answers are grounded in this paper and cite their sources.
May indicate subclinical immune activation in post-HTx restrictive filling; hypothesis-generating for transcriptomic surveillance beyond histology.
BACKGROUND: Diastolic dysfunction is a recognized chronic allograft complication, and a restrictive left ventricular filling pattern is associated with adverse outcomes. However, the underlying pathophysiological mechanisms remain unclear. METHODS AND Temporal analysis revealed that these pathways were downregulated from 1 to 5 years in the non-restrictive group but remained persistently activated in the restrictive group. CONCLUSIONS: The development of a restrictive filling pattern is associated with elevated intracardiac pressures and a persistent immune-related transcriptome signature, despite no histological evidence of rejection.
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Takahari et al. (2026) conducted a cohort in Heart transplant recipients (n=32). Restrictive left ventricular filling pattern vs. Non-restrictive left ventricular filling pattern was evaluated on Enrichment of allograft rejection pathway on transcriptome analysis at 5 years (NES 2.26, p=<0.001). The development of a restrictive left ventricular filling pattern 5 years after heart transplantation was associated with a persistent immune-related transcriptome signature, including allograft rejection pathways, despite no histological evidence of rejection.
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