Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Elevated pulmonary vascular resistance is superior to mean transpulmonary gradient in predicting right heart failure after heart transplantation: a 12-year single center analysis.
Session:
Posters 2 - Écran 08 - Circulação Pulmonar
Speaker:
Christopher Strong
Congress:
CPC 2018
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.8 Cardiovascular Surgery - Transplantation
Session Type:
Posters
FP Number:
---
Authors:
Christopher Strong; António Tralhão; Carlos Aguiar; Maria José Rebocho; Tiago Nolasco; Marta Marques; António Ventosa; Miguel Mendes; Miguel Abecassis; José Pedro Neves
Abstract
<p><strong>Background</strong></p> <p>Right heart failure (RHF) after heart transplantation (HTx) may adversely affect prognosis. Risk prediction is mostly based on invasive hemodynamic data but there is no consensus about the single best parameter to aid in risk stratification. We sought to compare the ability of usual right heart catheterization (RHC) derived parameters in predicting RHF after HTx.</p> <p><strong>Methods</strong></p> <p>Single-center retrospective study of all adult patients undergoing orthotopic bicaval HTx between January 2006 and November 2017 in a single-center. Pulmonary artery (PA) pressures (mean [mPAP], diastolic [dPAP]), transpulmonary gradients (mean [mTPG], diastolic [dTPG]) and pulmonary vascular resistance (PVR) were obtained from each patient’s last RHC before HTx. RHF after HTx was defined as right ventricular dilatation (right ventricle/left ventricle basal diameter > 1) and dysfunction (tricuspid annular systolic plane excursion < 12 mm) on transthoracic echocardiography plus signs of end-organ dysfunction (creatinin increase > 0.5 mg/dL from baseline or spontaneous prothrombin time > 14 s), without a plausible alternative cause. Univariate and multivariate analysis were performed to find independent predictors of RHF and receiver operating curve (ROC) analysis was used to assess discriminative power.</p> <p><strong>Results</strong></p> <p>Fifty-eight heart transplant patients were identified and analyzed (mean age 51 11 years, 58 % male). The most frequent etiologies were ischemic heart disease (n = 21) and dilated idiopathic cardiomyopathy (n = 16). Pre-operative PVR was 3.3 2.1 Wood units, mean PAP was 38 10 mmHg, dPAP was 27 mmHg and mTPG and dTPG were 10 5.3 and 3.5 mmHg, respectively. 14% of patients (n = 8) were on inotropic support and 10% (n = 6) required pre-HTx mechanical circulatory support (MCS). After HTx, RHF incidence was 5.2 % (n = 3) and one patient required temporary right ventricular MCS. In univariate analysis, elevated PVR, mTPG, mPAP and dPAP were associated with increased incidence of RHF. After multivariate logistic regression modelling, only PVR remained significantly associated with post-HTx RHF (OR 1.60 [CI 95% 1.1 - 2.6], p = 0.03). ROC curve analysis using PVR as the discriminator yielded a C-statistic of 0.813 [CI 95% 0.723 - 1.000, p < 0.031) for RHF occurrence after HTx. In a mean follow-up of 4.2 years, overall mortality was not different between those with RHF and those without (p=1.0).</p> <p><strong>Conclusions</strong></p> <p>In our population, RHF after HTx was an uncommon finding. Elevated PVR seemed to be superior to other RHC derived parameters in predicting RHF following HTx.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site