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Predicted Heart Mass: A Tale of 2 Ventricles.
Ródenas-Alesina, Eduard; Foroutan, Farid; Fan, Chun-Po; Stehlik, Josef; Bartlett, Ina; Tremblay-Gravel, Maxime; Aleksova, Natasha; Rao, Vivek; Miller, Robert J H; Khush, Kiran K; Ross, Heather J; Moayedi, Yasbanoo.
Afiliación
  • Ródenas-Alesina E; Ted Rogers Centre for Heart Research (E.R.-A., I.B., N.A., H.J.R., Y.M.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Foroutan F; Ted Rogers Computational Program (F.F., C.-P.S.F.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Fan CP; Ted Rogers Computational Program (F.F., C.-P.S.F.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Stehlik J; Division of Cardiovascular Medicine, Department of Medicine, University of Utah School of Medicine, Salt Lake City (J.S.).
  • Bartlett I; Ted Rogers Centre for Heart Research (E.R.-A., I.B., N.A., H.J.R., Y.M.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Tremblay-Gravel M; Division of Cardiology, Universite de Montreal, Quebec, QC, Canada (M.T.-G.).
  • Aleksova N; Ted Rogers Centre for Heart Research (E.R.-A., I.B., N.A., H.J.R., Y.M.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Rao V; Department of Cardiovascular Surgery, Cardiac Transplant, and Mechanical Circulatory Support, University Health Network, Toronto, ON, Canada (V.R.).
  • Miller RJH; Division of Cardiology, University of Calgary, AB, Canada (R.J.H.M.).
  • Khush KK; Division of Cardiovascular Medicine, Department of Medicine, Stanford University, CA (K.K.K.).
  • Ross HJ; Ted Rogers Centre for Heart Research (E.R.-A., I.B., N.A., H.J.R., Y.M.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
  • Moayedi Y; Ted Rogers Centre for Heart Research (E.R.-A., I.B., N.A., H.J.R., Y.M.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
Circ Heart Fail ; 16(9): e008311, 2023 09.
Article en En | MEDLINE | ID: mdl-37602381
ABSTRACT

BACKGROUND:

Total predicted heart mass (PHM) is the recommended metric to assess donor-recipient size matching in patients undergoing heart transplantation. Separately measuring right ventricular (RV) and left ventricular (LV) PHM may improve risk prediction of 1-year graft failure.

METHODS:

Adult heart transplant recipients from the UNOS database from 2000 to 2018 were included in the study. LV and RV PHM were modeled as restricted cubic splines. The association with 1-year graft failure was determined using adjusted Cox regression. The risk reclassification of using both LV and RV PHM versus total PHM was assessed using the net reclassification index.

RESULTS:

A total of 34 976 recipients were included. We observed a U-shaped association between total PHM and 1-year graft failure, such that risk increased for hearts undersized by >15% and those oversized by more than 27%. Graft failure incrementally increased when LV PHM was undersized by more than 5% and when RV was oversized by >20%. There was 1.5-fold greater risk of graft failure for an LV undersized by >26% or an RV oversized by more than 40%. Using LV and RV PHM risk-assessment separately led to a net reclassification index=8.5% ([95% CI, 5.3%-11.7%], nonevent net reclassification index=9.1%, event net reclassification index=-0.6%).

CONCLUSIONS:

The association between donor-recipient PHM match and the risk of graft failure after heart transplantation can be further understood as risk attributable to LV undersizing and RV oversizing. Assessing LV and RV PHM separately instead of total PHM could further refine the methods used to match donors and recipients for heart transplantation, minimize the risk of 1-year graft failure, and increase the use of donor organs.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trasplante de Corazón / Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Circ Heart Fail Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trasplante de Corazón / Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Circ Heart Fail Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Canadá