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, Soon J Park, W. K. Kremers, B. S. Edwards, N. L. Pereira

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)132-139
Number of pages8
JournalAmerican Journal of Transplantation
Volume9
Issue number1
DOIs
StatePublished - Jan 1 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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