title: High and low pulmonary vascular resistance in heart transplant candidates. A 5-year follow-up after heart transplantation shows continuous reduction in resistance and no difference in complication rate.
abstract: BACKGROUND
  In heart transplantation candidates, high pulmonary vascular resistance has been found to decrease promptly after heart transplantation without any further reduction during follow-up. Pulmonary hypertension has been described as associated with an increased peri- and postoperative complication rate and mortality. This study describes the evolution of pulmonary vascular resistance and the outcome for patients during 5 years following heart transplantation.
  
  
  RESULTS
  Haemodynamic data, complication rate and mortality have been analysed during 5-year follow-up in all patients (n = 80) who were heart transplanted at Sahlgrenska University Hospital from 1988 through 1990. We found a significant and continuous reduction in pulmonary vascular resistance both in patients with a pre-operative high (> 3 Wood Units; n = 36), but reversible on nitroprusside, and pre-operative low (< or = 3 Wood Units; n = 44) pulmonary vascular resistance. A multivariate analysis showed that a pre-operative high mean pulmonary artery and low mean pulmonary capillary wedge pressure predicted the decline in pulmonary vascular resistance during 5 years after heart transplantation. The need for a postoperative assist device, complication rate, and early and late mortality were independent of the pre-operative level of pulmonary vascular resistance.
  
  
  CONCLUSIONS
  A continuous reduction in pulmonary vascular resistance during 5 years following heart transplantation was found in patients with both high, but reversible, and low pre-operative resistance levels. The outcome and survival were independent of the pre-operative pulmonary vascular resistance level.
authors: Heart & Lung Transplantation Group, Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
authors: B
authors: B
authors: Lindelöw
authors: B
authors: B
authors: Andersson
authors: F
authors: F
authors: Waagstein
authors: C H
authors: CH
authors: Bergh
mesh_terms: D000293:Adolescent; D000328:Adult; D016534:Cardiac Output, High / Q000209:etiology* / Q000503:physiopathology; D002303:Cardiac Output, Low / Q000209:etiology* / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014655:Vascular Resistance / Q000502:physiology