Left ventricular function, tricuspid incompetence, and incidence of coronary artery disease late after orthotopic heart transplantation
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
G HerrmannH G Borst
Functional results and data concerning the incidence and severity of graft atherosclerosis (GASC) and tricuspid incompetence (TI) in the intermediate term after orthotopic heart transplantation (HTX) are still striking. We examined 92 patients 1, 2, and 3 years after HTX by right and left heart catheterization in order to evaluate pump function, the status of the coronary arteries and the extend of TI, using a double indicator thermodilation technique. Mean left ventricular volumes and ejection fraction were normal 1 and 2 years post-transplant. The incidence of GASC was 8/87 (9.2%) at 1, and 11/92 (12%) at 2 years. It was more frequent (16%) in patients with preexisting coronary artery disease (IHD) than in patients with underlying dilative cardiomyopathy (DCM) (11%). At the end of the 1st postoperative year, 62% of patients were free of TI, whereas only 38% had normal valve function 2 years posttransplant. In 9/14 (64%) of patients, consecutively assessed at 1 and 2 years, TI had increased between both investigations. Preoperative haemodynamics, the number of endomyocardial biopsies and rejection episodes as well as preoperative cardiac size did not correlate with TI. Left ventricular volumes and ejection fraction are normal ...Continue Reading
Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.