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Could CMV viremia have an impact on heart transplant patients
Session:
Posters (Sessão 1 - Écran 5) - Doença Vascular e Cirurgia Cardíaca
Speaker:
Ana Raquel Carvalho Santos
Congress:
CPC 2022
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
25.1 Invasive Imaging and Functional Assessment
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Raquel Carvalho Santos; António Valentim Gonçalves; Tiago Pereira-Da- Silva; Rui Soares; Rita Ilhão Moreira; Lídia de Sousa; Francisco Barbas de Albuquerque; José Viegas; Alexandra Castelo; Vera Ferreira; Pedro Brás; João Reis; Tania Mano; Tiago Mendonça; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Cytomegalovirus (CMV) viremia is associated with an increased risk of cardiac allograft vasculopathy, the major limiting factor for long-term survival after heart transplantation. It induces inflammation, myocyte damage, ischemia and fibrosis, resulting in cardiac dysfunction. These should be easily detectable yet the quest for a sufficiently sensitive, specific, and conclusive marker has been elusive.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Purpose: </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Compare the differences in transthoracic echocardiography (TTE) and right heart catheterization (RHC) parameters in patients with and without CMV viremia.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods: A retrospective analysis of consecutive HT patients submitted to RHC between February 2016 and November 2021, who performed TTE and blood CMV PCR at the same day, was made. An independent T-test was performed to evaluate the association between several TTE and RHC parameters in CMV positive and negative patients. Statistical differences with a p-value <0.05 were considered significant. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results: A total of 127 RHC were performed during the study period. The patients mean age was 50 years, 79% (n=100) were male, mean left ventricular ejection fraction (LVEF) 58 ± 10% and mean BNP 808 ± 984 pg/mL. There were 10% (n=13) CMV positive patients, with viral loads between 57 and 15300UI/mL (mean 1457,4, median 139). Mean values and respective p values of several TTE and RHC parameters between CMV positive and negative patients are depicted in Table 1. CMV positive patients had lower LVEF (49.90 ± 10.91% Vs 58.41 ± 9.91%, p=0.006) and higher systolic pulmonary arterial pressure (PAP) (40.89 ± 8.65mmHg Vs 67 ± 7.62mmHg, p<0.001) by TTE, as well as higher mean PAP (24.92 ± 7.06mmHg Vs 20.33 ± 7.03mHg, p=0.017) and right atrial pressure (2.09 ± 0.71mmHg Vs 1.59 ± 0.85, p=0.025) by RHC. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: </span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Heart Transplant patients with CMV viremia had significantly lower LVEF, higher PAP and higher right atrial pressure than patients without CMV viremia. The hemodynamic imbalance caused by this virus is reinforced by this research.</span></span></p>
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