Fall in pulmonary vascular resistance in patients awaiting heart transplantation.
BACKGROUND
Raised pulmonary vascular resistance is associated with decreased survival after orthotopic heart transplantation and patients with this risk factor are usually denied transplantation. In a proportion of cases raised pulmonary vascular resistance may fall with time and medical treatment.


METHODS
Seven patients with high pulmonary vascular resistance (range 3.9-6.6 Wood units) at initial assessment for cardiac transplantation were restudied by right heart catheterisation after a period of seven to 17 months.


RESULTS
In five of the seven patients the pulmonary vascular resistance had fallen, allowing orthotopic heart transplantation to be performed in four. In one patient the resistance was static and in one it had risen. The mean fall in pulmonary vascular resistance for the group was (mean (SD)) 2.6 (2.7) Wood units, p < 0.05.


CONCLUSIONS
Patients who have been denied transplantation on the basis of their raised pulmonary vascular resistance should be reassessed after four to six months if they remain otherwise clinically suitable.
Grant
S C
SC
Department of Cardiology, Wythenshawe Hospital, Manchester.
Levy
R D
RD
Brooks
N H
NH
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D003327:Coronary Disease / Q000503:physiopathology*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology*; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents