Document Type
Article
Publication Date
12-27-1995
Identifier
DOI: 10.1097/00007890-199560120-00017
Abstract
Early left ventricular (LV) remodeling following pediatric cardiac transplantation has not been described. To identify patterns and determinants of change in left ventricular mass and volume posttransplant, we studied 125 consecutive children who underwent cardiac transplantation between January 1, 1989 and July 31, 1993. Two-dimensional imaging-directed M-mode echocardiograms were studied weekly until 26 weeks post-transplant. LV mass and volume (indexed to BSA1.5) were measured. LV mass index increased until 3 weeks post-transplant, and then decreased. The mean decrement in LV mass index after 8 weeks post-transplant (relative to baseline) was significantly larger in patients with donor-recipient weight ratio > 1.5 compared with patients with donor-recipient weight ratio < or = 1.5 (-2.2 g/m3 compared with 33.4 g/m3, respectively, P < 0.01). Multiple linear regression was performed employing donor-recipient weight ratio, time since transplantation, ischemic time, and age at transplant as prognostic variables. Donor-recipient weight ratio (P < 0.0001), time since transplant (P < 0.01), and age at transplant (P = 0.02) were identified as independent predictors of change in LV mass index. Donor-recipient weight ratio (P = 0.001) and time since transplantation (P = 0.02) were independent predictors of change in LV volume index. There was an interaction between donor-recipient weight ratio and time since transplantation, suggesting that donor-recipient weight ratio has an independent effect as well as a time-dependent effect on change in LV mass and volume indices. LV mass and volume indices increased early posttransplant and then decreased; this pattern was temporally predictable, and dependent on donor-recipient weight ratio and age at transplant.
Journal Title
Transplantation
Volume
60
Issue
12
First Page
1467
Last Page
1472
MeSH Keywords
Child, Preschool; Female; Graft Survival; Heart Transplantation; Heart Ventricles; Humans; Infant; Infant, Newborn; Male; Organ Size; Time Factors; Ventricular Function, Left
Recommended Citation
Shirali, G. S., Lombano, F., Beeson, W. L., Dyar, D. A., Mulla, N. F., Khan, A., Johnston, J. K., Chinnock, R. E., Gundry, S. R., Razzouk, A. J. Ventricular remodeling following infant-pediatric cardiac transplantation. Does age at transplantation or size disparity matter? Transplantation 60, 1467-1472 (1995).
Included in
Cardiology Commons, Cardiovascular System Commons, Congenital, Hereditary, and Neonatal Diseases and Abnormalities Commons, Pediatrics Commons, Surgery Commons, Surgical Procedures, Operative Commons