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High and low pulmonary vascular resistance in heart transplant candidates. A 5-year follow-up after heart transplantation shows continuous reduction in resistance and no difference in complication rate.

Artikel i vetenskaplig tidskrift
Författare Björn Lindelöw
Bert Andersson
Finn Waagstein
Claes-Håkan Bergh
Publicerad i European heart journal
Volym 20
Nummer/häfte 2
Sidor 148-56
ISSN 0195-668X
Publiceringsår 1999
Publicerad vid Wallenberglaboratoriet
Hjärt-kärlinstitutionen
Sidor 148-56
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Adult, Cardiac Output, High, etiology, physiopathology, Cardiac Output, Low, etiology, physiopathology, Cardiomyopathy, Dilated, mortality, surgery, Female, Follow-Up Studies, Graft Survival, Heart Transplantation, adverse effects, mortality, Hemodynamics, physiology, Humans, Hypertension, Pulmonary, etiology, mortality, physiopathology, Male, Middle Aged, Prognosis, Statistics, Nonparametric, Survival Rate, Vascular Resistance, physiology
Ämneskategorier Kardiologi

Sammanfattning

In heart transplantation candidates, high pulmonary vascular resistance has been found to decrease promptly after heart transplantation without any further reduction during follow-up. Pulmonary hypertension has been described as associated with an increased peri- and postoperative complication rate and mortality. This study describes the evolution of pulmonary vascular resistance and the outcome for patients during 5 years following heart transplantation.Haemodynamic data, complication rate and mortality have been analysed during 5-year follow-up in all patients (n = 80) who were heart transplanted at Sahlgrenska University Hospital from 1988 through 1990. We found a significant and continuous reduction in pulmonary vascular resistance both in patients with a pre-operative high (> 3 Wood Units; n = 36), but reversible on nitroprusside, and pre-operative low (< or = 3 Wood Units; n = 44) pulmonary vascular resistance. A multivariate analysis showed that a pre-operative high mean pulmonary artery and low mean pulmonary capillary wedge pressure predicted the decline in pulmonary vascular resistance during 5 years after heart transplantation. The need for a postoperative assist device, complication rate, and early and late mortality were independent of the pre-operative level of pulmonary vascular resistance.A continuous reduction in pulmonary vascular resistance during 5 years following heart transplantation was found in patients with both high, but reversible, and low pre-operative resistance levels. The outcome and survival were independent of the pre-operative pulmonary vascular resistance level.

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