What question did this study set out to answer?

To evaluate the prognostic impact of early post-transplant hemodynamic variables measured at one year on five-year mortality and re-transplantation in heart transplant recipients.

November 19, 2019IJC Heart & VasculatureOpen Access

Early post-transplant elevated pulmonary artery pressure predicts adverse outcome in cardiac recipients

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Why the study?

The prognostic value of early post-transplant hemodynamic measurements on 5-year mortality in cardiac recipients was unknown.

Does elevated mean pulmonary artery pressure at one year post-transplant predict death or re-transplantation in cardiac recipients?

Key Points

To evaluate the prognostic impact of early post-transplant hemodynamic variables measured at one year on five-year mortality and re-transplantation in heart transplant recipients.
Conducted right heart catheterization in 290 heart transplant recipients during their routine one-year post-transplantation evaluation.
Stratified the cohort into percentiles for hemodynamic parameters, comparing the upper 10th percentile to the lower 90th percentile for RAP, MPAP, PAWP, and PVR, and the lower 10th percentile to the upper 90th percentile for cardiac index.
Death or re-transplantation occurred in 44 recipients (13%) within 5 years, with 20 events (45%) caused by graft failure and 24 (55%) caused by non-cardiac complications.
Patients with mean pulmonary artery pressure > 23 mmHg had a significantly higher risk of death or re-transplantation than those with MPAP ≤ 23 mmHg (HR 3.22, 95% CI 1.49–6.97; P = 0.003), which persisted after comorbidity adjustment.
No significant outcome differences were found when stratifying recipients by right atrial pressure, pulmonary artery wedge pressure, cardiac index, or pulmonary vascular resistance.

Structured PICO

Does elevated mean pulmonary artery pressure at one year post-transplant predict death or re-transplantation in cardiac recipients?

Population

290 heart transplantation (HTx) recipients undergoing right heart catheterization at a one-year post-HTx evaluation

Intervention

Elevated mean pulmonary artery pressure (MPAP > 23 mmHg)

Comparator

Normal mean pulmonary artery pressure (MPAP ≤ 23 mmHg)

Outcome

Death or re-transplantation within 5 years after the one-year controlhard clinical

Discussion

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Implication

Elevated mean pulmonary artery pressure (>23 mmHg) at one year post-heart transplant is a strong independent predictor of 5-year mortality or re-transplantation.

Cite This Study

Bollano et al. (2019) studied this question.

synapsesocial.com/papers/6a6f71adac440176ef281e02 https://doi.org/10.1016/j.ijcha.2019.100438

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Implication

Elevated mean pulmonary artery pressure (>23 mmHg) at one year post-heart transplant is a strong independent predictor of 5-year mortality or re-transplantation.

Early post-transplant elevated pulmonary artery pressure predicts adverse outcome in cardiac recipients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Early post-transplant elevated pulmonary artery pressure predicts adverse outcome in cardiac recipients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider