| Association of pediatric heart transplant coronary vasculopathy with abnormal hemodynamic measures. | |
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MedLine Citation:
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PMID: 21426526 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Objective. Transplant coronary artery disease (TCAD) is the limiting factor to long-term cardiac allograft survival; however, presymptomatic diagnosis remains challenging. To that concern, we evaluated the association of abnormal catheter-derived filling pressures with TCAD in pediatric heart transplant (HTx) recipients. Design, Patients, Outcome Measures. Data from 52 presymptomatic pediatric HTx patients were analyzed. Catheter-derived right ventricular end-diastolic pressure (RVEDP) and pulmonary capillary wedge pressure (PCWP) were recorded. Biopsies were collected to verify the absence of rejection. Results. TCAD was diagnosed an average of 8.3 years post-HTx in 20 (38%) patients, six of whom died and four of whom underwent retransplantation. Catheter-derived pressure measurements showed that RVEDP was elevated in TCAD compared with non-TCAD patients (9.5 ± 6.0 vs. 5.4 ± 4.7; P= .005), as was the PCWP (12.9 ± 5.7 vs. 9.1 ± 5.7; P= .012). Results from logistic regression analysis showed RVEDP > 10 mm Hg or PCWP > 12 mm Hg was associated with TCAD (OR = 5.2; P= .010). Conclusions. In this series, elevated ventricular filling pressures measured during routine surveillance catheterizations were associated with angiographic TCAD. Recognizing the association between elevated RVEDP/PCWP and TCAD may prompt earlier diagnosis and treatment of this potentially lethal process. |
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Authors:
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Ranjit Aiyagari; Melisa Nika; James G Gurney; Janet E Donohue; Mary C Zamberlan; Karen King; Dennis C Crowley; Robert J Gajarski |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Congenital heart disease Volume: 6 ISSN: 1747-0803 ISO Abbreviation: Congenit Heart Dis Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101256510 Medline TA: Congenit Heart Dis Country: United States |
Other Details:
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Languages: eng Pagination: 128-33 Citation Subset: IM |
Copyright Information:
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© 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc. |
Affiliation:
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C.S. Mott Children's Hospital, Division of Pediatric Cardiology, University of Michigan Health Center, Ann Arbor, MI, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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