title: Reverse ventricular remodeling and improved ventricular compliance after heart transplantation in infants and young children.
abstract: After heart transplantation (HT) in infants and young children, environmental and intrinsic factors may lead to changes in the geometry and compliance of the donor heart. Serial demographic, clinical, hemodynamic, and echocardiographic data were obtained from HT recipients younger than 4 years of age. Echocardiographic chamber measurement z-scores were compared using recipient body surface area from the time of HT to 1 week, 3 months, and last follow-up visit. Left ventricular end-diastolic volume (LVEDV) z-scores were correlated with pulmonary capillary wedge pressure (PCWP) at each time point. Heart transplantation was performed for 13 children between March 2009 and December 2012, 9 of whom (69%) were boys. The median age at HT was 8 months (range, 4-43 months), and the mean follow-up period was 13 ± 7 months. Left ventricular end-diastolic dimension z-scores decreased significantly (p = 0.03) between HT and 1 week, then increased from 1 week to 3 and 12 months. (-1.32 ± 1.7, -0.71 ± 1.8, 0.41 ± 2.1, 0.79 ± 2.3, respectively). A positive relationship (R(2) = 0.48) between the LVEDV z-score and PCPW was present at the last follow-up visit. For infants and young children, the allograft demonstrates appropriate growth by 1 year after HT. Left ventricular compliance improves over time.
authors: Division of Pediatric Cardiology, Department of Pediatrics, The Mount Sinai Medical Center, New York, NY, USA, kanwal.farooqi@mssm.edu.
authors: Kanwal M
authors: KM
authors: Farooqi
authors: Leo
authors: L
authors: Lopez
authors: Robert H
authors: RH
authors: Pass
authors: Daphne T
authors: DT
authors: Hsu
authors: Jacqueline M
authors: JM
authors: Lamour
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods; D005260:Female; D006085:Graft Survival; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods; D006352:Heart Ventricles / Q000254:growth & development / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D011184:Postoperative Period; D011669:Pulmonary Wedge Pressure; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D019737:Transplants / Q000254:growth & development / Q000276:immunology / Q000503:physiopathology; D016896:Treatment Outcome; D014481:United States; D020257:Ventricular Remodeling / Q000502:physiology*