Severe Left Ventricular Hypertrophy 1 Year After Transplant Predicts Mortality in Cardiac Transplant Recipients

Randy Goodroe, D. Dirk Bonnema, Shayna Lunsford, Phillip Anderson, Barbara Ryan-Baille, Walt Uber, John Ikonomidis, Arthur J. Crumbley, Adrian VanBakel, Michael R. Zile, Naveen Pereira

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Background: Left ventricular hypertrophy (LVH) is a known predictor of morbidity and mortality in patients with essential hypertension. The prevalence and significance of LVH in heart transplant recipients is unknown. Methods: Transthoracic echocardiograms were performed as part of a routine protocol 1 year after heart transplantation in 141 consecutive patients. Demographic and echocardiographic data were collected using patients' records and center-specific data from the Cardiac Transplant Research Database and analyzed to determine the prevalence and predictors of LVH at 1 year post-transplantation. Patients were divided into three groups based on left ventricular mass (LVM): normal (LVM <150 g); mild-moderate LVH (LVM 150 to 250 g); and severe LVH (LVM >250 g). Results: LVH was common at 1 year after heart transplantation, present in 83% of heart transplant recipients. Univariate predictors of severe LVH were increased body mass index (p < 0.01), pre-transplant diabetes mellitus (p = 0.02) and pre-transplant hypertension (p = 0.01). By multivariate analysis, pre-transplant hypertension was the only independent predictor of severe LVH (hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.1 to 5.4, p = 0.05). Heart transplant recipients with severe LVH had significantly decreased survival, as compared to patients with normal LVM and mild-moderate LVH (p = 0.03). After multivariate analysis adjusting for age, race, gender, pre-transplant hypertension and diabetes, severe LVH remained a strong, independent predictor of mortality (HR 3.6, 95% CI 1.0 to 12.1, p = 0.04). Conclusions: LVH is common at 1 year after heart transplantation and is a strong, independent predictor of increased mortality. Hypertension before transplantation is an independent predictor of the presence of severe LVH at 1 year after heart transplantation.

Original languageEnglish (US)
Pages (from-to)145-151
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2007

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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