Document Detail


Distribution and declines in cardiac allograft radionuclide left ventricular ejection fractions in relation to late mortality.
MedLine Citation:
PMID:  11295579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac allograft left ventricular ejection fraction (LVEF) is an important measure of left ventricular systolic function. Despite widespread use of LVEF after transplantation, its normal range and prognostic value in cardiac allografts has not been defined. METHODS: We conducted a retrospective cohort study among 292 consecutive adult heart transplant patients. Left ventricular ejection fractions were performed at 1, 3, 12, 24, and 48 months after transplantation using radionuclide ventriculography. Endomyocardial biopsies assessed rejection, right heart catheterization assessed loading conditions, and angiography assessed allograft coronary artery disease. We used Cox proportional hazards model to examine the predictive value of LVEF on late mortality. RESULTS: Of the patients who survived > or =4 years, the mean allograft LVEF decreased 4.7 units at 3 months, from 63.8 to 59.7; an additional 4.1 units at 12 months, from 59.7 to 55.6 (p < 0.001); and remained stable afterward. These changes were not associated with concurrent changes in loading conditions, episodes of rejection, or development of allograft coronary artery disease. Left ventricular ejection fraction lower than the 95% normal limit (<40%) at 12 months was inversely associated with risk for late cardiac mortality (relative risk = 3.5, 95% confidence interval = 1.0-12.2), while controlling for recipient age, sex, donor age, and rejection episodes. CONCLUSIONS: The cardiac-allograft LVEF frequently decreases in the first year after transplantation. The 95th percentile of allograft LVEF value (<40%) at Year 1 predicts late cardiac mortality among transplant recipients.
Authors:
R E Hershberger; H Ni; W Toy; R A Wilson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  20     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-11     Completed Date:  2001-07-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-24     Citation Subset:  IM    
Affiliation:
The Oregon Cardiac Transplant Program, Oregon Health Sciences University, Portland, Oregon 97201-3098, USA. hershber@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Cohort Studies
Female
Heart Transplantation / mortality,  physiology*,  radionuclide imaging
Hemodynamics / physiology
Humans
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Radionuclide Ventriculography
Retrospective Studies
Stroke Volume / physiology*
Survival Analysis
Transplantation, Homologous
Ventricular Function, Left / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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