Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality

Academic Article

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. © 2009 The Authors.
  • Published In

    Digital Object Identifier (doi)

    Pubmed Id

  • 20656725
  • Author List

  • Raichlin E; Villarraga HR; Chandrasekaran K; Clavell AL; Frantz RP; Kushwaha SS; Rodeheffer RJ; McGregor CG; Daly RC; Park SJ
  • Start Page

  • 132
  • End Page

  • 139
  • Volume

  • 9
  • Issue

  • 1