@article{cb2aa9e0-4347-472a-b255-e1affe0b492c,
  abstract     = {{Background<br/>Post-transplant diabetes mellitus (PTDM) is common after orthotopic heart transplantation (OHT), but its long-term impact on myocardial function is unclear. We aimed to evaluate the effects of PTDM on left ventricular (LV) systolic function.<br/>Methods<br/>We prospectively studied 102 OHT recipients with echocardiographic follow-up at 1-, 3-, and 5-year post-transplant. Patients were classified according to PTDM status at 1 year. LV systolic function was assessed using ejection fraction (EF) and global longitudinal strain (GLS). Linear mixed-effects models were used to evaluate longitudinal associations, adjusting for age, sex, systolic blood pressure, and cardiac allograft vasculopathy (CAV).<br/>Results<br/>PTDM was present in 36% of patients. At 1-year, EF and GLS were similar between groups. At 3 years, patients with PTDM exhibited significantly lower systolic function as assessed by GLS (−14.9±2.8 vs. −16.0±3.0%, p=0.022), and at 5-years, EF was also significantly lower (52±4 vs. 57±7%, p=0.002). In longitudinal analyses, PTDM was associated with persistently impaired GLS without a significant interaction with time (p=0.192). In contrast, EF demonstrated a significant PTDM×time interaction (p=0.039), reflecting a greater decline over time in patients with PTDM. These associations remained significant after adjustment for CAV, which was not independently associated with GLS or EF.<br/>Conclusion<br/>PTDM after OHT is associated with early and persistent impairment in myocardial deformation, followed by a progressive decline in systolic function. These findings suggest a metabolically mediated myocardial effect independent of chronic graft failure and highlight the importance of early detection and management of PTDM in heart transplant recipients.}},
  author       = {{Werther Evaldsson, Anna and Labaf, Ashkan and Gjesdal, Grunde and Jumatate, Raluca and Braun, Oscar and Smith, Jan Gustav and Ingvarsson, Annika}},
  issn         = {{2950-1334}},
  keywords     = {{heart transplantation; post transplant diabetes mellitus; global longitudinal strain; Left ventricular function}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Elsevier}},
  series       = {{JHLT Open}},
  title        = {{Post-Transplant Diabetes Is Associated With Late Systolic Left Ventricular Dysfunction After Heart Transplantation}},
  url          = {{http://dx.doi.org/10.1016/j.jhlto.2026.100622}},
  doi          = {{10.1016/j.jhlto.2026.100622}},
  year         = {{2026}},
}