Hemodynamic parameters one and four weeks after cardiac transplantation

Hemodynamic Characteristics Including Pulmonary Hypertension at Rest and During Exercise Before and After Heart Transplantation

“…In contrast to exercise hemodynamics after HT, several studies have evaluated hemodynamics at rest early and late after HT. [41][42][43][45][46][47][48][49][50][51][52][53][54][55][56] In line with those reports, we showed that even at 1 week after HT, resting hemodynamics improved dramatically and were maintained throughout the first year after HT. Pulmonary artery pressures as well as CO, SV, TPVR, and LVSWI continued to improve during the first year after HT (Figures 4 and 5).…”

“…Nonetheless, considering that the TPG and TPVR responses to exercise in our patients were comparable to previous results in patients with HF, 19 we believe that our observations are representative with regard to hemodynamics for patients with severe HF. Finally, previous studies have shown that rejections, 43,44,48,60 ischemic time of the donor heart, 43,44,48,60 and systemic hypertension 44,60 do not account for the hemodynamic abnormalities seen after HT. It is possible, however, that other donor characteristics and donor-recipient mismatches as well as patients' medical therapies may influence the findings.…”

“…This is supported in that the denervated heart, due to lack of sympathetic stimulation, is more dependent on the Frank Starling mechanism than is the innervated heart . Factors such as lack of heart rate reserve and Bainbridge reflex, rejections, fluid retention, hypertension, myocardial ischemia, and diastolic dysfunction have also been suggested to account for post‐transplant abnormalities . These studies, however, show diverging results.…”

“…40,58,59 Factors such as lack of heart rate reserve and Bainbridge reflex, rejections, fluid retention, hypertension, myocardial ischemia, and diastolic dysfunction have also been suggested to account for post-transplant abnormalities. [42][43][44]47,48 These studies, however, show diverging results. The ultimate cause remains unclear and possibly is multifactorial.…”

Interpretation of cardiac pathophysiology from pressure waveform analysis: Pericardial compressive hemodynamics, part 1

“…No biopsy evidence of transplant rejection was found. Because pericardial effusion and abnormal hemodynamics of this type have been described early after cardiac transplant [5,6], diuretics, nitrates and isoproterenol were prescribed, but without effect on jugular venous distension or dyspnea on minimal exertion. One week later, the patient was dyspneic with a systolic blood pressure of 85mmHg and a pulsus paradoxus (> 10mmHg) not previously observed ( Fig.…”