Cardiac allograft systolic function. Is the aetiology (ischaemic or idiopathic) a determinant of ventricular function in the heart transplant patient?

M. J. Antunes, M. Biernat, E. Sola, L. Oliveira, D. Prieto, F. Franco, L. A. Providencia
2008 Interactive Cardiovascular and Thoracic Surgery  
The natural history of the LV systolic function (LV-SF) and functional capacity of survivors of heart transplantation (Htx) has not been defined. Some investigators suggest that SF may be different in recipients with different pre-transplant aetiologies: ischaemic or dilated, idiopathic disease. Routine transthoracic echocardiograms (TTE) were performed during a 1-year follow-up in 48 Htx recipients (total 864 examinations; mean 18ypatient). Patients were divided into two groups based on
more » ... ups based on pre-transplant diagnosis: ischaemic (CAD-CMP: ns13, age 54"1.7 years, 23% females) and idiopathic dilated cardiomyopathy (ID-CMP: ns35, age 51"2.3 years, 26% females). Patients with valvular and toxic aetiology were excluded. All patients underwent left ventriculography (VENT) 12-15 months after Htx. The majority of 1-year survivors of Htx maintained normal LV-SF: mean LVEF 65"4% by echocardiography and 68"3% by ventriculography, but in the ID-CMP group LVEF was significantly higher: 67"4% vs. 62"4% (TTE) and 77"4% vs. 60"4% (VENT), without significant differences in functional capacity (NYHA). 82.9% of ID-CMP patients had LVEF )65% vs. 39% in CAD-CMP. The incidence of acute cellular rejection, freedom from cardiac vasculopathy, renal failure, diabetes, hypertension and pre-transplant alloantibody level was similar. Our study shows a strong correlation between pre-transplant heart disease and the systolic function of the cardiac allograft at 1-year follow-up.
doi:10.1510/icvts.2007.167924 pmid:18469010 fatcat:ovkw62ufxvhupcyafhwfjz3tma