Transpulmonary Gradient as a Predictor of Outcomes after Heart Transplantation
| Autor: | J.M. Liao, B.W. Hardaway, Jama Jahanyar, Eric Steidley, R.J. Butterfield, Robert L. Scott, Nan Zhang |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Inotrope Heart transplantation Transplantation medicine.medical_specialty business.industry medicine.medical_treatment Right heart failure Internal medicine Cardiology Medicine Pulmonary venous congestion Surgery Clinical significance Risk factor Cardiology and Cardiovascular Medicine business Pulmonary wedge pressure Transpulmonary pressure |
| Zdroj: | The Journal of Heart and Lung Transplantation. 38:S390 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2019.01.993 |
| Popis: | Purpose Transpulmonary pressure gradient (TPG) – the difference between mean pulmonary arterial pressure and pulmonary capillary wedge pressure – is increased in left-heart conditions associated pulmonary venous congestion. This is a risk factor for right heart failure after heart transplantation (HT). We assessed the clinical significance of TPG by assessing its role in predicting hospital length of stay (LOS) and survival after HT. Methods We queried the UNOS database from 1987 to 2017, and included adults with complete TPG data who underwent HT. Re-transplant patients were excluded. Eligible patients were divided into low ( 15) TPG. We compared demographics, mean hospital LOS, and extended LOS (LOS >14 days) with Wilcoxon and Chi-square-test. Survival time, as well as 5-year and 10-year survival was evaluated with Kaplan-Meir and compared between groups with Log-rank tests. Results Our sample consisted of 38,243 patients. Low and high TPG groups varied with respect to certain demographics. Median survival was higher in the low TPG group (145 vs 133 months in high TPG group, p Conclusion High TPG was associated with a lower survival and a longer hospital LOS after HT. Future work should expand on these findings and explore factors such as whether survival and LOS differences relate to post-transplant right ventricular failure, which requires prolonged inotropic support and can also affect overall survival. |
| Databáze: | OpenAIRE |
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