title: [Prognosis of heart transplant candidates stabilized on medical therapy].
abstract: OBJECTIVE
  A significant percentage of patients selected as candidates for heart transplantation can be stabilized by medical treatment, thereby enabling indefinite postponement of inclusion on the operation list. The aim of this study was to investigate the prognosis of these patients.
  
  
  METHODS
  We studied retrospectively 118 patients with severe left ventricular systolic dysfunction (ejection fraction < or = 35%) who were consecutively evaluated for cardiac transplantation but who did not undergo transplantation because they became clinically stable on medical treatment. The mean follow-up period was 2.14 (2.19) years. Kaplan-Meier survival analysis, and univariate and multivariate Cox proportional risk analyses of factors predicting survival were performed.
  
  
  RESULTS
  There were 18 deaths (15.2%): 12 were sudden (66.7%), 5 were due to heart failure (27.8%), and 1, to a non-cardiac cause (5.5%). The survival rate was 88% in the first year and 82% in the following 2 years. Univariate analysis showed that the parameters associated with mortality (P< or =.05) were pulmonary artery and capillary wedge pressures, diuretic treatment, and the absence of beta-blocker therapy. In the multivariate analysis, only the absence of beta-blocker therapy remained statistically significant (P=.003; RR = 0.13; 95%CI, 0.03-0.50).
  
  
  CONCLUSIONS
  In a population of patients with severe left ventricular systolic dysfunction who were candidates for heart transplantation but who were stabilized by medical therapy, mortality during the first year of follow-up was 12%. Beta-blocker therapy was the only variable associated with better survival.
authors.affiliation: Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. jfernandezy.hgugm@salud.madrid.org
authors.forename: Juan
authors.initials: J
authors.lastname: Fernández-Yáñez
authors.forename: Jesús
authors.initials: J
authors.lastname: Palomo
authors.forename: Esteban G
authors.initials: EG
authors.lastname: Torrecilla
authors.forename: David
authors.initials: D
authors.lastname: Pascual
authors.forename: Gregorio
authors.initials: G
authors.lastname: Garrido
authors.forename: José J
authors.initials: JJ
authors.lastname: Gómez de Diego
authors.forename: Marta
authors.initials: M
authors.lastname: Domínguez
authors.forename: Jesús
authors.initials: J
authors.lastname: Almendral
mesh_terms: D000465:Algorithms; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000628:therapy*