Long-term function of human cardiac allografts assessed by two-dimensional echocardiography.
Previous studies from our laboratory demonstrated increasing left ventricular mass in cyclosporine-treated cardiac allograft recipients over 30 days after transplantation, but the long-term evolution of this process and possible effects on allograft function are unknown. Accordingly, quantitative two-dimensional echocardiography was performed 2 and 23 days and 15 months postoperatively in 14 recipients treated with cyclosporine and prednisone. Changes in left ventricular ejection fraction, end-diastolic volume, mass, and end-systolic wall stress were analyzed. Comparison of studies at 2 and 23 days revealed significant (p less than 0.01) increases in ejection fraction (54% +/- 8% [standard deviation] to 62% +/- 4%), end-diastolic volume (84% +/- 32 ml to 96 +/- 31 ml), and left ventricular mass (118 +/- 45 gm to 136 +/- 41 gm). Comparison of studies at 23 days and 15 months revealed no significant change in end-diastolic volume or left ventricular mass, whereas ejection fraction decreased slightly (62% +/- 4% to 57% +/- 4%, p less than 0.01). End-systolic wall stress decreased when data at 2 days and 15 months were compared (83 +/- 24 gm/cm2 versus 66 +/- 18 gm/cm2, p less than 0.05), but no change in contractility was apparent from the ejection fraction/end-systolic stress relation. We conclude that left ventricular mass and end-diastolic volume increase early after transplantation in cyclosporine-treated cardiac allograft recipients, but these changes are not predictive of long-term results, which are characterized by no significant late variation in left ventricular mass, end-diastolic volume, or contractility.
Antunes
M L
ML
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, N.Y.
Spotnitz
H M
HM
Clark
M B
MB
Steinhardt
M J
MJ
Marboe
C C
CC
Smith
C R
CR
Rose
E A
EA
Reemtsma
K
K
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001794:Blood Pressure; D006332:Cardiomegaly / Q000139:chemically induced / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000009:adverse effects / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D013318:Stroke Volume
D003524:Cyclosporins; D011241:Prednisone