Stability of right and left ventricular ejection fractions and volumes after heart transplantation.
BACKGROUND
The long-term stability of right ventricular (RV) and left ventricular (LV) volume and function after heart transplantation has not been well characterized. Accordingly, the objective of this study was to assess time- and rejection-dependent changes in RV and LV function and volume after cardiac transplantation by means of a recently validated 3-dimensional tomographic equilibrium radionuclide ventriculography approach.


METHODS
A total of 71 consecutive patients (age, mean +/- SD, 57 +/- 12 years; 62 men; 9 women) were studied 5 +/- 4 years (range 1--16 years) after heart transplantation. The mean frequency of >Grade 2 rejection was 1.7 +/- 1.8 episodes (range 0--7 episodes). RV and LV ejection fraction (EF) and end-diastolic volume (EDV) in transplant patients were compared with data from 34 subjects at low likelihood for coronary artery disease.


RESULTS
No significant differences in RV or LV EF or EDV compared with controls were observed (RV EF=54 +/- 9 vs 53 +/- 9; RV EDV [ml]=109 +/- 35 vs 120 +/- 32; LV EF=72 +/- 8 vs 73 +/- 9; and LV EDV [ml]=108 +/- 28 vs 98 +/- 20 for controls and patients with transplants, respectively; p=NS for all comparisons). There was no significant effect on RV or LV EF or volumes with rejection, or with time after transplantation.


CONCLUSIONS
RV as well as LV EF and EDV are stable more than 1 year after heart transplantation for up to 16 years. Thus, changes in EF or EDV in the transplanted heart are abnormal and should prompt a clinical evaluation.
Streeter
Rebecca P
RP
Division of Cardiology, Department of Medicine, College of Physician and Surgeons, New York, New York 10003, USA.
Nichols
Kenneth
K
Bergmann
Steven R
SR
D000328:Adult; D000368:Aged; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*