Ventricular remodeling after orthotopic cardiac transplantation.

Abstract

Significant right and left ventricular remodeling occurs between 1 month and 12 months after orthotopic cardiac transplantation, with progressive cavity dilatation but reduction in global left ventricular muscle mass. These adjustments, especially in the left ventricle, tend to reduce the volume/mass ratio by 1 year and are compatible with normalization of ventricular wall tension between the early and late scan dates. Routine clinical measurements of ejection fraction alone mask the almost parallel increases in stroke volume and end-diastolic volume during the first 12 months after orthotopic cardiac transplantation.

Effect of diltiazem on exercise capacity after heart transplantation

“…Taken together, our study suggests that diltiazem treatment during the first year after HTx reduces HR, may improve cardiac allograft function 13,42 and improve exercise tolerance in HTx recipients. The beneficial effects of diltiazem on cardiac allograft function, its ability to lower HR, improve blood pressure control, 21 reduce progression of coronary allograft vasculopathy 22 and improve exercise tolerance in addition to its CNI-sparing effect and low cost make diltiazem a preferable medication to use after HTx.…”

“…Our previous studies 13, 33 and Vigneswaran et al 42 demonstrated that post-HTx sinus tachycardia can lead to shortening diastolic filling time resulting in decrease in SV 13,42 and CI. Similar to these findings, in the present study echocardiographic markers of cardiac allograft systolic function, LVEF, and SV, significantly raised compared to baseline in the diltiazem treated patients, and there was a trend toward its increase in the diltiazem group compared to controls at 1-year follow-up.…”

Echocardiographic assessment of chamber size and ventricular function during the first year after heart transplantation

“…The natural time course of RV size is not well described, with conflicting data. In a small study consisting of only 10 patients RV size increased between 1 and 12 months (Vigneswaran, Rumberger, Rodeheffer, Breen, & McGregor, 1996).…”

Diastolic Dysfunction in Human Cardiac Allografts is Related with Reduced SERCA2a Gene Expression

“…Expression of all candidate genes was assessed simultaneously in endomyocardial biopsies obtained from cardiac allografts >1 year post‐transplant. This limitation should exclude the likelihood of multiple gene expression changes that accompany the dynamic cardiac allograft modeling process in the first post‐operative year (15). Results from quantitative gene expression measurements were related with IVRT at the time of biopsy.…”