BACKGROUND: The purpose of this investigation was to determine the influence of pre-existing pulmonary hypertension (PHT) on outcome and to assess the pulmonary hemodynamic changes after heart transplantation (HT). METHODS: A total of 410 patients were studied before and after (1 month and 1 year) HT: Group 1 (n = 266) had no PHT (PVR < 3 Wood units [WU], TPG < 10 mm Hg); Group 2 (n = 112) had mild-moderate PHT (PVR 3 to 6 WU, TPG 10 to 20 mm Hg); and Group 3 (n = 32) had severe PHT (PVR > 6 WU, TPG > 20 mm Hg). RESULTS: Mean (+/- SD) follow-up was 5.2 +/- 4.1 years, mean recipient age was 57 +/- 11, and mean donor age was 30 +/- 12 years. Baseline characteristics were similar in all groups, except donor/recipient weight ratio, which was higher in patients with PHT (p = 0.002). There was a significant (p < 0.0001) decrease in mean TPG to 11.0 within the first month and to 9.5 mm Hg after the first year. Decreases in PVR to 2.2 and 2.0 WU at 1 month and 1 year, respectively (p < 0.0001 for both) were also found. Reversibility (after vasodilation) of PHT was obtained in 85% of patients in Group 2 and in 84% in Group 3. Patients' PHT did not show a significant difference in 30-day mortality (p = 0.9) and long-term survival (p = 0.8). Patients with residual post-transplant PHT (PVR > or = 3 WU) had reduced long-term survival (p = 0.03). Multivariate analysis showed no evidence that elevated PVR was associated with death. CONCLUSIONS: Pre-existing elevated PVR that responds to vasodilator challenge does not have a negative influence on short- and long-term survival after HT. We found that residual post-transplant PHT is associated with decreased long-term survival.
BACKGROUND: The purpose of this investigation was to determine the influence of pre-existing pulmonary hypertension (PHT) on outcome and to assess the pulmonary hemodynamic changes after heart transplantation (HT). METHODS: A total of 410 patients were studied before and after (1 month and 1 year) HT: Group 1 (n = 266) had no PHT (PVR < 3 Wood units [WU], TPG < 10 mm Hg); Group 2 (n = 112) had mild-moderate PHT (PVR 3 to 6 WU, TPG 10 to 20 mm Hg); and Group 3 (n = 32) had severe PHT (PVR > 6 WU, TPG > 20 mm Hg). RESULTS: Mean (+/- SD) follow-up was 5.2 +/- 4.1 years, mean recipient age was 57 +/- 11, and mean donor age was 30 +/- 12 years. Baseline characteristics were similar in all groups, except donor/recipient weight ratio, which was higher in patients with PHT (p = 0.002). There was a significant (p < 0.0001) decrease in mean TPG to 11.0 within the first month and to 9.5 mm Hg after the first year. Decreases in PVR to 2.2 and 2.0 WU at 1 month and 1 year, respectively (p < 0.0001 for both) were also found. Reversibility (after vasodilation) of PHT was obtained in 85% of patients in Group 2 and in 84% in Group 3. Patients' PHT did not show a significant difference in 30-day mortality (p = 0.9) and long-term survival (p = 0.8). Patients with residual post-transplant PHT (PVR > or = 3 WU) had reduced long-term survival (p = 0.03). Multivariate analysis showed no evidence that elevated PVR was associated with death. CONCLUSIONS: Pre-existing elevated PVR that responds to vasodilator challenge does not have a negative influence on short- and long-term survival after HT. We found that residual post-transplant PHT is associated with decreased long-term survival.
Authors: Ryan J Tedford; Claude A Beaty; Stephen C Mathai; Todd M Kolb; Rachel Damico; Paul M Hassoun; Peter J Leary; David A Kass; Ashish S Shah Journal: J Heart Lung Transplant Date: 2013-11-28 Impact factor: 10.247
Authors: Cecile Tissot; Shannon Buckvold; Christina M Phelps; D Dunbar Ivy; David N Campbell; Max B Mitchell; Suzanne Osorio da Cruz; Bill A Pietra; Shelley D Miyamoto Journal: J Am Coll Cardiol Date: 2009-08-18 Impact factor: 24.094
Authors: Andreas P Kalogeropoulos; Vasiliki V Georgiopoulou; Barry A Borlaug; Mihai Gheorghiade; Javed Butler Journal: Circ Heart Fail Date: 2013-05 Impact factor: 8.790
Authors: Rasmus Rivinius; Matthias Helmschrott; Arjang Ruhparwar; Bastian Schmack; Fabrice F Darche; Dierk Thomas; Tom Bruckner; Andreas O Doesch; Hugo A Katus; Philipp Ehlermann Journal: ESC Heart Fail Date: 2020-02