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

E. Raichlin; H. R. Villarraga; K. Chandrasekaran; A. L. Clavell; R. P. Frantz; S. S. Kushwaha; R. J. Rodeheffer; C. G. McGregor; R. C. Daly; S. J. Park; W. K. Kremers; B. S. Edwards; N. L. Pereira

doi:10.1111/j.1600-6143.2008.02474.x

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

E. Raichlin, H. R. Villarraga, K. Chandrasekaran, A. L. Clavell, R. P. Frantz, S. S. Kushwaha, R. J. Rodeheffer, C. G. McGregor, R. C. Daly, S. J. Park, W. K. Kremers, B. S. Edwards, N. L. Pereira

Research output: Contribution to journal › Article › peer-review

29 Scopus citations

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	https://doi.org/10.1111/j.1600-6143.2008.02474.x
State	Published - Jan 2009

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)

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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. (2009). Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality. American Journal of Transplantation, 9(1), 132-139. https://doi.org/10.1111/j.1600-6143.2008.02474.x

Raichlin, E, Villarraga, HR, Chandrasekaran, K, Clavell, AL, Frantz, RP, Kushwaha, SS, Rodeheffer, RJ, McGregor, CG, Daly, RC, Park, SJ, Kremers, WK , Edwards, BS & Pereira, NL 2009, 'Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality', American Journal of Transplantation, vol. 9, no. 1, pp. 132-139. https://doi.org/10.1111/j.1600-6143.2008.02474.x

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title = "Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality",

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.",

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",

author = "E. Raichlin and Villarraga, {H. R.} and K. Chandrasekaran and Clavell, {A. L.} and Frantz, {R. P.} and Kushwaha, {S. S.} and Rodeheffer, {R. J.} and McGregor, {C. G.} and Daly, {R. C.} and Park, {S. J.} and Kremers, {W. K.} and Edwards, {B. S.} and Pereira, {N. L.}",

year = "2009",

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doi = "10.1111/j.1600-6143.2008.02474.x",

language = "English (US)",

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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

Y1 - 2009/1

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

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AN - SCOPUS:58049200727

SN - 1600-6135

VL - 9

SP - 132

EP - 139

JO - American Journal of Transplantation

JF - American Journal of Transplantation

IS - 1

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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