Reversal of constrictive/restrictive physiology with treatment of allograft rejection

Seacord, Lynne; Miller, Leslie W.; Pennington, D. Glenn; McBride, Lawrence R.; Kern, Morton J.

doi:10.1016/0002-8703(90)90103-5

Cited by 12 publications

(4 citation statements)

References 7 publications

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“…there are also specific factors directly related to heart transplantation that can further induce or accelerate diastolic dysfunction in cardiac allograft recipients [19][20][21][22][23][24][25][26][27] . These include myocardial denervation, volume overload due to a mismatch between the size of donor and recipient hearts 21 , the effect of allograft ischemic time during the surgery 22,26 , pericardial constriction because of pericardial effusion 25 , acute cardiac rejection 20,23,27 , myocardial ischemia due to significant post-transplant vasculopathy, and immune heart injury associated with persistent tumor necrosis factor-alpha expression 28 .…”

Section: Aspects Of Left Ventricular Filling Pressure Elevation and Dmentioning

confidence: 99%

“…These include myocardial denervation, volume overload due to a mismatch between the size of donor and recipient hearts 21 , the effect of allograft ischemic time during the surgery 22,26 , pericardial constriction because of pericardial effusion 25 , acute cardiac rejection 20,23,27 , myocardial ischemia due to significant post-transplant vasculopathy, and immune heart injury associated with persistent tumor necrosis factor-alpha expression 28 . Serious risk factors for diastolic dysfunction are also progressive myocardial hypertrophy and fibrosis due to immune injury 28 , long donor heart ischemic time during surgery 26 , and due to healing of reccurent episodes of myocardial rejection 24 .…”

Section: Aspects Of Left Ventricular Filling Pressure Elevation and Dmentioning

confidence: 99%

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High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients

Meluzı́n¹,

Hude²,

Leinveber³

et al. 2014

BIOMED PAP

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Aim. Post-heart transplant patients are at increased risk of diastolic dysfunction. The aim of this study was to assess the prevalence of isolated only exercise-induced heart failure with normal ejection fraction (HFNEF) in heart transplant recipients. Methods and Results. To determine pulmonary capillary wedge pressure (PCWP) at rest and during exercise, 81 patients after orthotopic heart transplantation with normal left ventricular ejection fraction (LVEF) underwent exercise right heart catheterization with simultaneous exercise echocardiography. Based on PCWP values, the patients were divided into three groups. Twenty-one patients had no evidence of HFNEF (PCWP at rest < 15 mmHg, maximal PCWP during exercise < 25 mmHg, prevalence 26%). Forty-seven subjects were found to have only exercise-induced HFNEF (PCWP at rest < 15 mmHg, maximal PCWP during exercise ≥ 25 mmHg, prevalence 58%). Thirteen patients had HFNEF already at rest (PCWP ≥ 15 mmHg at rest, prevalence 16%). Of the noninvasive parameters obtained at rest, multivariate regression analysis identified LV mass index adjusted for allograft age to be an independent predictor of exercise-induced HFNEF. Conclusions. In heart transplant recipients with normal LVEF, there is a high prevalence of exercise-induced HFNEF. LV mass index adjusted for allograft age is predictive of exercise-induced HFNEF.

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Section: Aspects Of Left Ventricular Filling Pressure Elevation and Dmentioning

confidence: 99%

Section: Aspects Of Left Ventricular Filling Pressure Elevation and Dmentioning

confidence: 99%

High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients

Meluzı́n¹,

Hude²,

Leinveber³

et al. 2014

BIOMED PAP

View full text Add to dashboard Cite

show abstract

“…Diastolic function assessed by transmitral Doppler diastolic indexes should allow the sensitive detection of acute rejection but their value is limited as they can be abnormal even in healthy patients ( 10 ). Nevertheless, diastolic dysfunction carries a prognostic value ( 40 ), and Doppler abnormalities in LV filling patterns have shown a return to baseline following episodes of rejection ( 41 ). TDI and relaxation velocities have been studied and results are not univocal, since, in some studies, it has been found that an association between decreased systolic and filling velocities and acute rejection ( 42 , 43 ) is not confirmed by others ( 44 ).…”

Section: Prognostic Implications Of Diastolic Assessmentmentioning

confidence: 99%

Diastolic function in heart transplant: From physiology to echocardiographic assessment and prognosis

Sciaccaluga

Fusi²,

Landra³

et al. 2022

Front. Cardiovasc. Med.

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Heart transplant (HTx) still represents the most effective therapy for end-stage heart failure, with a median survival time of 10 years. The transplanted heart shows peculiar physiology due to the profound alterations induced by the operation, which inevitably influences several echocardiographic parameters assessed during these patients’ follow-ups. With these premises, the diastolic function is one of the main aspects to take into consideration. The left atrium (LA) plays a key role in this matter, and that same chamber is significantly impaired with the transplant, with different degrees of altered function based on the surgical technique. Therefore, the traditional echocardiographic evaluation of diastolic function applied to the general population might not properly reflect the physiology of the graft. This review attempts to provide current evidence on diastolic function in HTx starting from defining its different physiology and how the standard echocardiographic parameters might be affected to its prognostic role. Furthermore, based on the experience of our center and the available evidence, we proposed an algorithm that might help clinicians distinguish from actual diastolic dysfunction from a normal diastolic pattern in HTx population.

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“…A 53-yr-old woman underwent orthotopic cardiac transplantation for dilated cardiomyopathy [3]. The postoperative course was uncomplicated.…”

Section: Pericardial Fluid After Cardiac Transplantation and Early Tamentioning

confidence: 99%

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

Kern

Aguirre

1992

Cathet. Cardiovasc. Diagn.

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Reversal of constrictive/restrictive physiology with treatment of allograft rejection

Cited by 12 publications

References 7 publications

High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients

High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients

Diastolic function in heart transplant: From physiology to echocardiographic assessment and prognosis

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

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