Early post-transplant elevated pulmonary artery pressure predicts adverse outcome in cardiac recipients.
Heart transplantation
Hemodynamics
Pulmonary arterial hypertension
Journal
International journal of cardiology. Heart & vasculature
ISSN: 2352-9067
Titre abrégé: Int J Cardiol Heart Vasc
Pays: Ireland
ID NLM: 101649525
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
01
02
2019
revised:
19
06
2019
accepted:
02
11
2019
entrez:
27
11
2019
pubmed:
27
11
2019
medline:
27
11
2019
Statut:
epublish
Résumé
To investigate the prognostic value of early post-transplant hemodynamic measurements on 5-year mortality in cardiac recipients (HTx). A right heart catheterization was performed in 290 heart transplantation (HTx) recipients at a one-year post-HTx evaluation. To study the effect of post-HTx hemodynamic variables on 5-year outcome, the cohort was stratified into several subgroups. For right atrial pressure (RAP), mean pulmonary artery pressure (MPAP), pulmonary artery wedge pressure (PAWP), and pulmonary vascular resistance (PVR), patients with values from the upper 10th percentile (high), were compared with those with values from the remaining lower 90th percentile (normal). For cardiac index (CI), patients with values from the lower 10th percentile (low) were compared with those with values from the remaining upper 90th percentile (normal). Death or re-transplantation within 5 years after the one-year control occurred in 44 patients (13%). Of those, death or re-HTx was related to graft failure in 20 of cases (45%) and non-cardiac causes in 24 of cases (55%). The risk of death or re-HTx was higher in the subgroup with MPAP above 23 mmHg than those equal to or below this value [hazard ratio 3.22, 95% confidence interval (CI) 1.49-6.97; Elevated pulmonary artery pressure at a first annual evaluation after HTx was the only hemodynamic variable that predicted impaired outcome in cardiac recipients.
Identifiants
pubmed: 31768416
doi: 10.1016/j.ijcha.2019.100438
pii: S2352-9067(19)30163-0
pii: 100438
pmc: PMC6872849
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100438Informations de copyright
© 2019 The Authors. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
The authors report no relationships that could be construed as a conflict of interest.
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