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Preoperative pulmonary hypertension and its impact on survival after heart transplantation.

Lundgren, Jakob LU ; Algotsson, Lars LU ; Kornhall, Björn LU and Rådegran, Göran LU (2014) In Scandinavian Cardiovascular Journal 48(1). p.47-58
Abstract
Abstract Objectives. Pulmonary hypertension (PH) due to left heart disease may impair outcome after heart transplantation (HT). To evaluate to what extent previous, and present, haemodynamic criteria discriminate the impact of pre-operative-PH on survival, we characterized the PH in our HT-patients according to ESC's guidelines, ISHLT's summary statement and ISHLT's relative contraindications and criteria for early risk of death after HT. Design. Records from the 215 HT-patients in Lund during 1988-2010 were reviewed. Subsequent analysis included adults (n = 94) evaluated with right-heart-catheterization at our lab, at rest before HT. End of follow-up was 30th of June 2012. Results. Survival (mean, n) did not differ (p = ns) for the 94... (More)
Abstract Objectives. Pulmonary hypertension (PH) due to left heart disease may impair outcome after heart transplantation (HT). To evaluate to what extent previous, and present, haemodynamic criteria discriminate the impact of pre-operative-PH on survival, we characterized the PH in our HT-patients according to ESC's guidelines, ISHLT's summary statement and ISHLT's relative contraindications and criteria for early risk of death after HT. Design. Records from the 215 HT-patients in Lund during 1988-2010 were reviewed. Subsequent analysis included adults (n = 94) evaluated with right-heart-catheterization at our lab, at rest before HT. End of follow-up was 30th of June 2012. Results. Survival (mean, n) did not differ (p = ns) for the 94 HT-patients; without (13.0 years, n = 28) or with (13.9 years, n = 66) PH, passive (13.8 years, n = 50) or reactive (12.2 years, n = 13) post-capillary-PH, "modified" passive (13.1 years, n = 40), mixed (16.6 years, n = 23), "modified" reactive (12.6 years, n = 7) or non-reactive (12.2 years, n = 8) post-capillary-PH; or for ISHLT's relative contraindications (12.0 years, n = 22) or increased risk of right-heart-failure and early death (16.5 years, n = 23) after HT. Conclusions. As previous and present haemodynamic criteria did not sufficiently discriminate the impact of pre-operative-PH for survival after HT at our centre, larger multi-centre studies are encouraged to redefine criteria that may influence outcome. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Scandinavian Cardiovascular Journal
volume
48
issue
1
pages
47 - 58
publisher
Taylor & Francis
external identifiers
  • pmid:24460475
  • wos:000330849500008
  • scopus:84893235368
ISSN
1651-2006
DOI
10.3109/14017431.2013.877153
language
English
LU publication?
yes
id
da9fe912-8219-4bb8-a978-cc746f4eba14 (old id 4290713)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24460475?dopt=Abstract
date added to LUP
2014-02-07 13:59:07
date last changed
2017-04-16 03:05:13
@article{da9fe912-8219-4bb8-a978-cc746f4eba14,
  abstract     = {Abstract Objectives. Pulmonary hypertension (PH) due to left heart disease may impair outcome after heart transplantation (HT). To evaluate to what extent previous, and present, haemodynamic criteria discriminate the impact of pre-operative-PH on survival, we characterized the PH in our HT-patients according to ESC's guidelines, ISHLT's summary statement and ISHLT's relative contraindications and criteria for early risk of death after HT. Design. Records from the 215 HT-patients in Lund during 1988-2010 were reviewed. Subsequent analysis included adults (n = 94) evaluated with right-heart-catheterization at our lab, at rest before HT. End of follow-up was 30th of June 2012. Results. Survival (mean, n) did not differ (p = ns) for the 94 HT-patients; without (13.0 years, n = 28) or with (13.9 years, n = 66) PH, passive (13.8 years, n = 50) or reactive (12.2 years, n = 13) post-capillary-PH, "modified" passive (13.1 years, n = 40), mixed (16.6 years, n = 23), "modified" reactive (12.6 years, n = 7) or non-reactive (12.2 years, n = 8) post-capillary-PH; or for ISHLT's relative contraindications (12.0 years, n = 22) or increased risk of right-heart-failure and early death (16.5 years, n = 23) after HT. Conclusions. As previous and present haemodynamic criteria did not sufficiently discriminate the impact of pre-operative-PH for survival after HT at our centre, larger multi-centre studies are encouraged to redefine criteria that may influence outcome.},
  author       = {Lundgren, Jakob and Algotsson, Lars and Kornhall, Björn and Rådegran, Göran},
  issn         = {1651-2006},
  language     = {eng},
  number       = {1},
  pages        = {47--58},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal},
  title        = {Preoperative pulmonary hypertension and its impact on survival after heart transplantation.},
  url          = {http://dx.doi.org/10.3109/14017431.2013.877153},
  volume       = {48},
  year         = {2014},
}