Showing papers by "Ilan S. Wittstein published in 2001"
TL;DR: Enalaprilat attenuates beta-adrenergic contractility and enhances left ventricular distensibility in patients with idiopathic dilated cardiomyopathy, but not in subjects with normalleft ventricular function.
52 citations
01 Jan 2001
TL;DR: There is increasing evidence that patients with hemodynamic compromise and cardiac allograft dysfunction who have minimal evidence of lymphocytic infiltration on biopsy illustrate a distinct form of rejection mediated primarily by the humoral immune system in which the allografted vasculature is the primary target of injury.
Abstract: Since the introduction of endomyocardial biopsy for routine rejection surveillance, the diagnosis of acute rejection has been based primarily on the presence and extent of lymphocytic infiltration.1,2 Acute cardiac allograft rejection has been considered primarily a T cell phenomenon mediated by the cellular arm of the immune system. In recent years, however, several centers have reported patients with hemodynamic compromise and cardiac allograft dysfunction who have minimal evidence of lymphocytic infiltration on biopsy.3–5 There is increasing evidence that these cases illustrate a distinct form of rejection mediated primarily by the humoral immune system in which the allograft vasculature is the primary target of injury.4,6–10 The idea of an antibody mediated vascular rejection is supported by the kidney transplant literature where the role of humoral immunity in acute allograft rejection has been recognized for almost 30 years,11–18 and where antibody mediated vascular injury in the absence of interstitial infiltrates has been well described.19,20