Document Detail


Static and dynamic predictors of adverse events in patients with intermediate cardiopulmonary capacity referred for heart transplantation.
MedLine Citation:
PMID:  16399535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic heart failure (CHF) patients with intermediate cardiopulmonary capacity referred for heart transplantation are at "medium risk," and are not amenable to further stratification based solely on peak VO(2.) Accordingly, we analyzed whether time-related and/or non-time-related parameters could provide incremental prognostic information in CHF patients with intermediate cardiopulmonary capacity. METHODS: We analyzed 134 patients with a peak VO(2) of 10 to 18 ml/kg/min (age 54 +/- 9 years, 66% males) and a left ventricular ejection fraction (LVEF) of 27% +/- 8% who underwent an extensive clinical/instrumental (electrocardiogram, echocardiogram, cardiopulmonary exercise test) index evaluation; for all patients, an equivalent pre-study evaluation (performed >or=6 months before) was also available. RESULTS: Among index-evaluation parameters, systolic blood pressure (p < 0.001), LVEF (p = 0.036), and presence of severe mitral regurgitation (p = 0.006) independently predicted cardiac death/need for heart transplantation. Stable clinical condition from pre-study to index-evaluation accompanied by <10% QRS widening and <10% decrease in peak VO(2) provided incremental prognostic information with respect to all index-evaluation parameters (p = 0.014). CONCLUSIONS: CHF patients with intermediate peak VO(2) who display "stable" CHF present a lower incidence of adverse cardiac events, particularly in the absence of hypotension, severe mitral regurgitation, and severe reduction of LVEF. Such a stratification might be clinically useful for deciding between medical treatment alone and consideration for heart transplantation.
Authors:
Francesco Grigioni; Antonio Russo; Luciano Potena; Alfonso Ielasi; Francesca Fabbri; Letizia Bacchi-Reggiani; Samuela Carigi; Anna C Musuraca; Mauro Bigliardi; Fabio Coccolo; Gaia Magnani; Salvatore Specchia; Carlo Magelli; Angelo Branzi
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Publication Detail:
Type:  Journal Article     Date:  2005-11-17
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  25     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-09     Completed Date:  2006-06-23     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:  85-9     Citation Subset:  IM    
Affiliation:
Institute of Cardiology, S. Orsola-Malpighi University Hospital, Bologna, Italy. francesco.grigioni@unibo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography
Electrocardiography
Exercise Test
Female
Heart Failure / complications,  surgery*
Heart Transplantation*
Humans
Male
Middle Aged
Mitral Valve Insufficiency
Oxygen Consumption*
Predictive Value of Tests
Prognosis
Referral and Consultation
Respiratory Function Tests
Retrospective Studies
Risk Assessment
Severity of Illness Index
Stroke Volume
Survival Analysis

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


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