Background: Abnormal glycaemia in orthotopic heart transplant (OHT)
recipients may result in AGEs formation. However the role of AGEs in development of acute rejection (AR) and coronary vasculopathy (CAV) is unknown. The Aim of the study was to localize AGEs in endomyocardial biopsies (EMBs) in order to correlate their presence with AR and CAV in OHT
subjects with and without DM.
Material/Methods: Elective EMBs performed 3y post OHT in 65 pts. with DM (60M/5F, 49±8y/o) and 24pts. without DM (21M/3F, 42±10y/o) were involved in the study. Localization of AGEs in myocardial paraffin sections was assessed immunochemically using mouse monoclonal anti-AGE antibodies. The presence of AGEs in cardiomyocytes, stromal cells, connective tissue cells and capillaries was described with semi-quantitative scale.
Results: Occurrence of AGEs was similar in both groups - cardiocytes 74 vs.
63%, stroma 34 vs. 33%, connective tissue 14 vs. 9%, and capillaries 32vs.33% - in DM vs. non-DM pts., while intensity of staining was significantly higher in DM subjects. Overall number of AR episodes and mean EMB score were significantly correlated with AGE presence in cardiomyocytes (r=0.31/0.25, p=0.011/0.049, Spearman test), but only in DM group. There was no relation between AGEs and CAV in DM pts., while time free from any angiographically confirmed CAV, and CAV related event was significantly longer in non-DM pts. with AGEs in cardiomyocytes and/or capillaries (p=0.017/0.014/0.03/0.014 respectively, log-rank test).
Conclusions: AGEs occurrence in DM subjects is related to AR, but does not predict CAV, while in non-DM patients it is correlated with AR, but prolongs freedom from CAV.

Keywords: Heart Transplantation