title: Cardiac allograft remodeling after heart transplantation is associated with increased graft vasculopathy and mortality.
abstract: The aim of this study was to assess the patterns, predictors and outcomes of left ventricular remodeling after heart transplantation (HTX). Routine echocardiographic studies were performed and analyzed at 1 week, 1 year and 3-5 years after HTX in 134 recipients. At each study point the total cohort was divided into three subgroups based on determination of left ventricle mass and relative wall thickness: (1) NG-normal geometry (2) CR-concentric remodeling and (3) CH-concentric hypertrophy. Abnormal left ventricular geometry was found as early as 1 week after HTX in 85% of patients. Explosive mode of donor brain death was the most significant determinant of CH (OR 2.9, p = 0.01) at 1 week. CH at 1 week (OR 2.72, p = 0.01), increased body mass index (OR 1.1, p = 0.01) and cytomegalovirus viremia (OR - 4.06, p = 0.02) were predictors of CH at 1 year. CH of the cardiac allograft at 1 year was associated with increased mortality as compared to NG (RR 1.87, p = 0.03). CR (RR 1.73, p = 0.027) and CH (RR 2.04, p = 0.008) of the cardiac allograft at 1 year is associated with increased subsequent graft arteriosclerosis as compared to NG.
authors.affiliation: Division of Cardiology, William J. Von Liebig Transplant Center, Mayo Clinic, Rochester, MN, USA.
authors.forename: E
authors.initials: E
authors.lastname: Raichlin
authors.forename: H R
authors.initials: HR
authors.lastname: Villarraga
authors.forename: K
authors.initials: K
authors.lastname: Chandrasekaran
authors.forename: A L
authors.initials: AL
authors.lastname: Clavell
authors.forename: R P
authors.initials: RP
authors.lastname: Frantz
authors.forename: S S
authors.initials: SS
authors.lastname: Kushwaha
authors.forename: R J
authors.initials: RJ
authors.lastname: Rodeheffer
authors.forename: C G
authors.initials: CG
authors.lastname: McGregor
authors.forename: R C
authors.initials: RC
authors.lastname: Daly
authors.forename: S J
authors.initials: SJ
authors.lastname: Park
authors.forename: W K
authors.initials: WK
authors.lastname: Kremers
authors.forename: B S
authors.initials: BS
authors.lastname: Edwards
authors.forename: N L
authors.initials: NL
authors.lastname: Pereira
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003331:Coronary Vessels / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014184:Transplantation, Homologous; D020257:Ventricular Remodeling