Donor-heart evaluation by monitoring the left ventricular pressure-volume relationship: clinical observations.
Fourteen donor hearts were assessed by measurement of dopamine requirement, basic hemodynamic parameters (for example, systolic blood pressure), and the left ventricular pressure-volume relationship. The latter function was measured by a combination microtipped manometer/conductance catheter placed in the left ventricle through the ascending aorta. With an isoproterenol dose 24 hours after transplantation as the measure of cardiac performance, multiple linear regression analysis indicated that the ratio of arterial elastance (Ea) to left ventricular end-systolic elastance (Ees), ventriculoarterial coupling (Ea/Ees), and myocardial ischemic time were good predictors of posttransplantation cardiac performance. Dopamine requirement and basic hemodynamic data were not. Twelve implanted hearts showed an Ea/Ees of less than 1.0 and showed good early (less than 24 hours) and late function. Two hearts considered on clinical grounds to be unsuitable for transplantation showed an Ea/Ees of more than 1.0. The data suggest that measurement of the left ventricular pressure-volume relationship would appear to be a clinically useful predictor of donor-heart performance after transplantation.
Yokoyama
Y
Y
Oklahoma Transplantation Institute, Baptist Medical Center, Oklahoma City.
Cooper
D K
DK
Sasaki
H
H
Snow
T R
TR
Akutsu
T
T
Zuhdi
N
N
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D001926:Brain Death / Q000503:physiopathology; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004298:Dopamine / Q000627:therapeutic use; D005260:Female; D016027:Heart Transplantation / Q000502:physiology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis; D014019:Tissue Donors; D016277:Ventricular Function, Left / Q000502:physiology*
D004298:Dopamine