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 1 2009 |
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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
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)
Cite this
Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality. / Raichlin, E.; Villarraga, H. R.; Chandrasekaran, K.; Clavell, A. L.; Frantz, R. P.; Kushwaha, S. S.; Rodeheffer, R. J.; McGregor, C. G.; Daly, R. C.; Park, S. J.; Kremers, W. K.; Edwards, B. S.; Pereira, N. L.
In: American Journal of Transplantation, Vol. 9, No. 1, 01.01.2009, p. 132-139.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality
AU - Raichlin, E.
AU - Villarraga, H. R.
AU - Chandrasekaran, K.
AU - Clavell, A. L.
AU - Frantz, R. P.
AU - Kushwaha, S. S.
AU - Rodeheffer, R. J.
AU - McGregor, C. G.
AU - Daly, R. C.
AU - Park, S. J.
AU - Kremers, W. K.
AU - Edwards, B. S.
AU - Pereira, N. L.
PY - 2009/1/1
Y1 - 2009/1/1
N2 - 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.
AB - 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.
KW - Brain death
KW - Cardiac allograft
KW - Cardiac allograft vasculopathy
KW - Cardiac complications
KW - Cardiac function
KW - Cardiac remodeling
KW - Cardiac transplant
KW - Clinical heart transplantation
KW - Cytomegalovirus (CMV)
KW - Left ventricular hypertrophy
KW - Obesity
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=58049200727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58049200727&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2008.02474.x
DO - 10.1111/j.1600-6143.2008.02474.x
M3 - Article
C2 - 19067662
AN - SCOPUS:58049200727
VL - 9
SP - 132
EP - 139
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 1
ER -