Abstract
The aim of this study was to assess the patterns, predictors and outcomes of left ventricular remodeling after heart transplantation (HTX). Routine echocardiographic studies were performed and analyzed at 1 week, 1 year and 3-5 years after HTX in 134 recipients. At each study point the total cohort was divided into three subgroups based on determination of left ventricle mass and relative wall thickness: (1) NG - normal geometry (2) CR - concentric remodeling and (3) CH - concentric hypertrophy. Abnormal left ventricular geometry was found as early as 1 week after HTX in 85% of patients. Explosive mode of donor brain death was the most significant determinant of CH (OR 2.9, p = 0.01) at 1 week. CH at 1 week (OR 2.72, p = 0.01), increased body mass index (OR 1.1, p = 0.01) and cytomegalovirus viremia (OR - 4.06, p = 0.02) were predictors of CH at 1 year. CH of the cardiac allograft at 1 year was associated with increased mortality as compared to NG (RR 1.87, p = 0.03). CR (RR 1.73, p = 0.027) and CH (RR 2.04, p = 0.008) of the cardiac allograft at 1 year is associated with increased subsequent graft arteriosclerosis as compared to NG.
Original language | English (US) |
---|---|
Pages (from-to) | 132-139 |
Number of pages | 8 |
Journal | American Journal of Transplantation |
Volume | 9 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2009 |
Externally published | Yes |
Keywords
- Brain death
- Cardiac allograft
- Cardiac allograft vasculopathy
- Cardiac complications
- Cardiac function
- Cardiac remodeling
- Cardiac transplant
- Clinical heart transplantation
- Cytomegalovirus (CMV)
- Left ventricular hypertrophy
- Obesity
- Outcomes