Donor–recipient predicted heart mass ratio and right ventricular–pulmonary arterial coupling in heart transplant
Abstract OBJECTIVES Right ventricular–pulmonary arterial (RV–PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was RV–PA coupling at 7 and 30 days after heart transplant and its association with donor–recipient size matching. METHODS Clinical,...
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| Published in: | European journal of cardio-thoracic surgery Vol. 59; no. 4; pp. 847 - 854 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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Oxford University Press
29-04-2021
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| Abstract | Abstract
OBJECTIVES
Right ventricular–pulmonary arterial (RV–PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was RV–PA coupling at 7 and 30 days after heart transplant and its association with donor–recipient size matching.
METHODS
Clinical, echocardiographic and haemodynamic data from a retrospective cohort of heart transplant recipients and respective donors were reviewed. Coupling between RV–PA was examined by assessing the RV fractional area change and pulmonary artery systolic pressure ratio. Donor–recipient size matching was assessed by the predicted heart mass (PHM) ratio, and groups with a PHM ratio <1 and ≥1 were compared.
RESULTS
Forty-four heart transplant recipients were included in this study (50 years, 57% male sex). Postoperative RV–PA coupling improved from 7 to 30 days (RV fractional area change/pulmonary artery systolic pressure 0.9 ± 0.3 vs 1.2 ± 0.3; P < 0.001). A positive association was found between an adequate PHM ratio and improvement of RV fractional area change/pulmonary artery systolic pressure at 30 days, independent of graft ischaemic time and pre-existent pulmonary hypertension (B coefficient 0.54; 95% confidence interval 0.11–0.97; P = 0.016; adjusted R2 = 0.24).
CONCLUSIONS
These findings highlight the role of PHM as a metric to help donor selection and suggest its impact in RV–PA coupling interactions post-heart transplant. |
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| AbstractList | OBJECTIVESRight ventricular-pulmonary arterial (RV-PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was RV-PA coupling at 7 and 30 days after heart transplant and its association with donor-recipient size matching. METHODSClinical, echocardiographic and haemodynamic data from a retrospective cohort of heart transplant recipients and respective donors were reviewed. Coupling between RV-PA was examined by assessing the RV fractional area change and pulmonary artery systolic pressure ratio. Donor-recipient size matching was assessed by the predicted heart mass (PHM) ratio, and groups with a PHM ratio <1 and ≥1 were compared. RESULTSForty-four heart transplant recipients were included in this study (50 years, 57% male sex). Postoperative RV-PA coupling improved from 7 to 30 days (RV fractional area change/pulmonary artery systolic pressure 0.9 ± 0.3 vs 1.2 ± 0.3; P < 0.001). A positive association was found between an adequate PHM ratio and improvement of RV fractional area change/pulmonary artery systolic pressure at 30 days, independent of graft ischaemic time and pre-existent pulmonary hypertension (B coefficient 0.54; 95% confidence interval 0.11-0.97; P = 0.016; adjusted R2 = 0.24). CONCLUSIONSThese findings highlight the role of PHM as a metric to help donor selection and suggest its impact in RV-PA coupling interactions post-heart transplant. Right ventricular-pulmonary arterial (RV-PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was RV-PA coupling at 7 and 30 days after heart transplant and its association with donor-recipient size matching. Clinical, echocardiographic and haemodynamic data from a retrospective cohort of heart transplant recipients and respective donors were reviewed. Coupling between RV-PA was examined by assessing the RV fractional area change and pulmonary artery systolic pressure ratio. Donor-recipient size matching was assessed by the predicted heart mass (PHM) ratio, and groups with a PHM ratio <1 and ≥1 were compared. Forty-four heart transplant recipients were included in this study (50 years, 57% male sex). Postoperative RV-PA coupling improved from 7 to 30 days (RV fractional area change/pulmonary artery systolic pressure 0.9 ± 0.3 vs 1.2 ± 0.3; P < 0.001). A positive association was found between an adequate PHM ratio and improvement of RV fractional area change/pulmonary artery systolic pressure at 30 days, independent of graft ischaemic time and pre-existent pulmonary hypertension (B coefficient 0.54; 95% confidence interval 0.11-0.97; P = 0.016; adjusted R2 = 0.24). These findings highlight the role of PHM as a metric to help donor selection and suggest its impact in RV-PA coupling interactions post-heart transplant. Abstract OBJECTIVES Right ventricular–pulmonary arterial (RV–PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was RV–PA coupling at 7 and 30 days after heart transplant and its association with donor–recipient size matching. METHODS Clinical, echocardiographic and haemodynamic data from a retrospective cohort of heart transplant recipients and respective donors were reviewed. Coupling between RV–PA was examined by assessing the RV fractional area change and pulmonary artery systolic pressure ratio. Donor–recipient size matching was assessed by the predicted heart mass (PHM) ratio, and groups with a PHM ratio <1 and ≥1 were compared. RESULTS Forty-four heart transplant recipients were included in this study (50 years, 57% male sex). Postoperative RV–PA coupling improved from 7 to 30 days (RV fractional area change/pulmonary artery systolic pressure 0.9 ± 0.3 vs 1.2 ± 0.3; P < 0.001). A positive association was found between an adequate PHM ratio and improvement of RV fractional area change/pulmonary artery systolic pressure at 30 days, independent of graft ischaemic time and pre-existent pulmonary hypertension (B coefficient 0.54; 95% confidence interval 0.11–0.97; P = 0.016; adjusted R2 = 0.24). CONCLUSIONS These findings highlight the role of PHM as a metric to help donor selection and suggest its impact in RV–PA coupling interactions post-heart transplant. |
| Author | Carrion, Luciana Goldraich, Livia Adams Hastenteufel, Laura Carolina Tavares Santos, Angela B S Clausell, Nadine Nazario, Raffaela de Almeida |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33860318$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.healun.2014.02.027 10.1016/j.echo.2014.10.003 10.1183/13993003.01913-2018 10.1016/S0735-1097(00)01102-5 10.1111/echo.13650 10.12659/AOT.909359 10.1016/j.healun.2018.03.009 10.1016/j.healun.2018.09.017 10.1016/j.amjcard.2017.03.003 10.1016/j.jacc.2016.10.047 10.1016/j.healun.2010.05.034 10.1111/ajt.14354 10.1152/ajpheart.00157.2013 10.1016/j.echo.2010.05.009 10.1016/j.healun.2011.01.721 10.1016/j.jchf.2013.09.005 10.1111/j.1540-8175.2012.01807.x 10.1016/j.jclinepi.2007.11.008 |
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| Keywords | Heart transplant Right ventricular–pulmonary arterial coupling Donor–recipient mismatch |
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| References | Kobashigawa (2021070807101494800_ezaa391-B3) 2014; 33 Reed (2021070807101494800_ezaa391-B9) 2014; 2 Costanzo (2021070807101494800_ezaa391-B8) 2010; 29 Vonk Noordegraaf (2021070807101494800_ezaa391-B4) 2017; 69 Simonneau (2021070807101494800_ezaa391-B13) 2019; 53 Antończyk (2021070807101494800_ezaa391-B18) 2018; 23 Segovia (2021070807101494800_ezaa391-B2) 2011; 30 Barakat (2021070807101494800_ezaa391-B1) 2017; 119 Kobashigawa (2021070807101494800_ezaa391-B7) 2017; 17 Meris (2021070807101494800_ezaa391-B15) 2010; 23 Ghio (2021070807101494800_ezaa391-B5) 2001; 37 Lang (2021070807101494800_ezaa391-B14) 2015; 28 Mastouri (2021070807101494800_ezaa391-B16) 2013; 30 Guazzi (2021070807101494800_ezaa391-B6) 2013; 305 Kransdorf (2021070807101494800_ezaa391-B11) 2019; 38 Gong (2021070807101494800_ezaa391-B10) 2018; 37 Von Elm (2021070807101494800_ezaa391-B12) 2008; 61 Simsek (2021070807101494800_ezaa391-B17) 2017; 34 |
| References_xml | – volume: 33 start-page: 327 year: 2014 ident: 2021070807101494800_ezaa391-B3 article-title: Report from a consensus conference on primary graft dysfunction after cardiac transplantation publication-title: J Heart Lung Transplant doi: 10.1016/j.healun.2014.02.027 contributor: fullname: Kobashigawa – volume: 28 start-page: 1 year: 2015 ident: 2021070807101494800_ezaa391-B14 article-title: Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging publication-title: J Am Soc Echocardiogr doi: 10.1016/j.echo.2014.10.003 contributor: fullname: Lang – volume: 53 start-page: 1801913 year: 2019 ident: 2021070807101494800_ezaa391-B13 article-title: Haemodynamic definitions and updated clinical classification of pulmonary hypertension publication-title: Eur Respir J doi: 10.1183/13993003.01913-2018 contributor: fullname: Simonneau – volume: 37 start-page: 183 year: 2001 ident: 2021070807101494800_ezaa391-B5 article-title: Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(00)01102-5 contributor: fullname: Ghio – volume: 34 start-page: 1432 year: 2017 ident: 2021070807101494800_ezaa391-B17 article-title: Assessment of right ventricular systolic function in heart transplant patients: correlation between echocardiography and cardiac magnetic resonance imaging. 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Right ventricular–pulmonary arterial (RV–PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of... Right ventricular-pulmonary arterial (RV-PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was RV-PA... OBJECTIVESRight ventricular-pulmonary arterial (RV-PA) coupling interactions are largely unexplored in heart transplant patients. The outcome of this study was... |
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