The Journal of Heart and Lung Transplantation最新文献

Right ventricular reserve in cardiopulmonary disease: a simultaneous hemodynamic and three-dimensional echocardiographic study.

The Journal of Heart and Lung Transplantation Pub Date : 2024-12-25 DOI: 10.1016/j.healun.2024.12.022

C Baratto,C Dewachter,K Forton,D Muraru,M F Gagliardi,M Tomaselli,M Gavazzoni,G B Perego,M Senni,A Bondue,L P Badano,G Parati,J L Vachiéry,S Caravita

{"title":"Right ventricular reserve in cardiopulmonary disease: a simultaneous hemodynamic and three-dimensional echocardiographic study.","authors":"C Baratto,C Dewachter,K Forton,D Muraru,M F Gagliardi,M Tomaselli,M Gavazzoni,G B Perego,M Senni,A Bondue,L P Badano,G Parati,J L Vachiéry,S Caravita","doi":"10.1016/j.healun.2024.12.022","DOIUrl":"https://doi.org/10.1016/j.healun.2024.12.022","url":null,"abstract":"BACKGROUNDRV reserve has been linked to exercise capacity and prognosis in cardiopulmonary diseases. However, evidence in this setting is limited, due to the complex shape and load dependency of the RV. We sought to study right ventricular (RV) adaptation to exercise by simultaneous three-dimensional echocardiography (3DE) and right heart catheterization (RHC).METHODSPatients with heart failure with preserved ejection fraction (HFpEF) or pulmonary vascular disease (PVD) underwent simultaneous supine rest/exercise RHC-3DE. They were subdivided based on RV ejection fraction (EF) changes: 1)exhausted RV reserve, RVEF-; 2)preserved RV reserve, RVEF+.RESULTSSixty percent of patients were RVEF-. Distribution of HFpEF/PVD, as well as RV volumes and RVEF at rest were similar in the two groups. Hemodynamic metrics of RV afterload, as well as their exercise-induced changes, were similar in the two groups. During exercise, RV end-diastolic volume increased more in RVEF- than in RVEF+ (29±29 vs 7±25 mL,p<0.05). RV end-systolic volume increased by 21[12;31]mL in RVEF- and decreased by 8[-15;1]mL in RVEF+ (p<0.001). RV-pulmonary artery coupling was lower in RVEF- at peak exercise(p<0.05). Peak RVEF was associated with left ventricular preload (R2=0.14,p=0.011). Cardiac output increased less in RVEF- than in RVEF+ (+2.3±2.0 vs +4.0±2.4 L/min,p<0.05). Peak RVEF was associated with oxygen consumption(p<0.01).CONCLUSIONSExhausted RV reserve, as evaluated by 3DE, was frequent in HFpEF and PVD, was relatively independent from classical afterload parameters, was associated with RV-pulmonary artery decoupling, RV dilation, enhanced ventricular interdependence, and cardiac limitation to exercise. Intrinsic RV dysfunction may contribute to exhausted RV reserve.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142887603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Approaches to Optimize Donor Heart for Transplantation.

The Journal of Heart and Lung Transplantation Pub Date : 2024-12-25 DOI: 10.1016/j.healun.2024.12.001

Amit H Alam,Candice Y Lee,Manreet K Kanwar,Yasbanoo Moayedi,Alexander M Bernhardt,Koji Takeda,Duc Thinh Pham,Christopher Salerno,Andreas Zuckermann,David D'Alessandro,Victor G Pretorius,John O Louca,Stephen Large,Dawn E Bowles,Scott C Silvestry,Nader Moazami

引用次数: 0

Identification and Validation of a Threshold for Early Posttransplant Bronchoalveolar Fluid Hyaluronan that Distinguishes Lung Recipients at Risk for CLAD. 确定并验证移植后早期支气管肺泡液透明质酸的阈值，以区分有 CLAD 风险的肺部受者。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-22 DOI: 10.1016/j.healun.2024.10.014

Jamie L Todd,Jeremy M Weber,Francine L Kelly,Andrew Nagler,Patrick McArthur,Lerin Eason,Jeeyon G Rim,Courtney W Frankel,John A Belperio,Marie Budev,Tereza Martinu,Kunal Patel,John M Reynolds,Pali D Shah,Lianne G Singer,Laurie D Snyder,Wayne Tsuang,S Sam Weigt,Megan L Neely,Scott M Palmer

{"title":"Identification and Validation of a Threshold for Early Posttransplant Bronchoalveolar Fluid Hyaluronan that Distinguishes Lung Recipients at Risk for CLAD.","authors":"Jamie L Todd,Jeremy M Weber,Francine L Kelly,Andrew Nagler,Patrick McArthur,Lerin Eason,Jeeyon G Rim,Courtney W Frankel,John A Belperio,Marie Budev,Tereza Martinu,Kunal Patel,John M Reynolds,Pali D Shah,Lianne G Singer,Laurie D Snyder,Wayne Tsuang,S Sam Weigt,Megan L Neely,Scott M Palmer","doi":"10.1016/j.healun.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.healun.2024.10.014","url":null,"abstract":"BACKGROUNDFew tools exist for early identification of patients at risk for chronic lung allograft dysfunction (CLAD). We previously showed hyaluronan (HA), a matrix molecule that regulates lung inflammation and fibrosis, accumulates in bronchoalveolar lavage fluid (BALF) and blood in CLAD. We aimed to determine if early posttransplant HA elevations inform CLAD risk.METHODSHA was quantified in 3080 BALF and 1323 blood samples collected over the first posttransplant year in 743 adult lung recipients at 5 centers. The relationship between BALF or blood HA and CLAD was assessed using Cox models with a time-dependent binary covariate for \"elevated\" HA. Potential thresholds for elevated HA were examined using a grid search between the 50th and 85th percentile. The optimal threshold was identified using fit statistics, and the association between the selected threshold and CLAD was internally validated through iterative resampling. A multivariable Cox model using the selected threshold was performed to evaluate the association of elevated HA with CLAD considering other factors that may influence CLAD risk.RESULTSBALF HA levels >19.1ng/mL (65th percentile), had the largest hazard ratio for CLAD (HR 1.70, 95% CI 1.25-1.31; p<0.001), optimized fit statistics, and demonstrated robust reproducibility. In a multivariable model, the occurrence of BALF HA >19.1 ng/mL in the first posttransplant year conferred a 66% increase in the hazards for CLAD (adjusted HR 1.66, 95% CI 1.19-2.32; p=0.003). Blood HA was not significantly associated with CLAD.CONCLUSIONSWe identified and validated a precise threshold for BALF HA in the first posttransplant year that distinguishes patients at increased CLAD risk.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Procurement Methods on Organ Rejection in Donation After Circulatory Death Heart Transplantation. 在循环死亡后心脏移植手术中，采购方法对器官排斥反应的影响。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-20 DOI: 10.1016/j.healun.2024.10.015

Ye In Christopher Kwon,Elizabeth Bashian,Arman Kilic,Zubair A Hashmi

引用次数: 0

iPhone or Blackberry? The unsure future of Ex-Vivo Lung Perfusion: A Commentary on Ex-Vivo Lung Perfusion National Trends and Post-Transplant Outcomes. iPhone 还是黑莓？体外肺灌注前途未卜：关于体外肺灌注全国趋势和移植后结果的评论。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-20 DOI: 10.1016/j.healun.2024.10.012

Gaurav Sharma,Michael E Jessen,Matthias Peltz

引用次数: 0

Impact of Tacrolimus vs. Cyclosporine on CLAD Incidence and Allograft Survival in the ISHLT Registry. 他克莫司与环孢素对 ISHLT 注册表中 CLAD 发病率和异体移植物存活率的影响。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-20 DOI: 10.1016/j.healun.2024.10.013

Michael P Combs,Krysta Walter,Haley Hixson,Elizabeth A Belloli,Matthew S Najor,Kevin M Chan,Andrew C Chang,Dennis M Lyu

{"title":"Impact of Tacrolimus vs. Cyclosporine on CLAD Incidence and Allograft Survival in the ISHLT Registry.","authors":"Michael P Combs,Krysta Walter,Haley Hixson,Elizabeth A Belloli,Matthew S Najor,Kevin M Chan,Andrew C Chang,Dennis M Lyu","doi":"10.1016/j.healun.2024.10.013","DOIUrl":"https://doi.org/10.1016/j.healun.2024.10.013","url":null,"abstract":"PURPOSEThe ScanCLAD study reported a lower incidence of CLAD with the use of once-daily tacrolimus vs. twice-daily cyclosporine. Using the ISHLT Thoracic Organ Transplant (TTX) Registry data, we evaluated the hypothesis that tacrolimus is superior to cyclosporine in real world clinical practice.METHODSThis study is a retrospective cohort study of adult lung transplant recipients in the ISHLT Registry from January 1, 2000 through June 30, 2018 with known CLAD status. The primary exposure variable was patients' maintenance calcineurin inhibitor (CNI) regimen captured at post-transplant discharge. The primary outcome variables were time to CLAD development (with death/retransplantation analyzed as a competing risk) and allograft survival (i.e., time to death/retransplant).RESULTSOf the 57,403 adult lung transplant recipients in the registry, 22,222 had both CNI and CLAD data available. Of these, 19,698 (88.6%) received tacrolimus immediate release (IR), 2,477 (11.2%) received cyclosporine, and 47 (0.2%) received tacrolimus extended release (XR) for maintenance CNI. Receiving cyclosporine for maintenance immunosuppression (vs. tacrolimus IR) was associated with an increased risk of developing CLAD (HR 1.16, 95% CI 1.08-1.23, p<0.001) and with an increased overall risk for death/retransplant (HR 1.16, 95% CI 1.09-1.23, p<0.001). Receiving tacrolimus XR vs. tacrolimus IR was not associated with differences in long-term post-transplant outcomes, although these analyses were limited by a small sample size.CONCLUSIONSPatients receiving cyclosporine vs. tacrolimus IR for maintenance calcineurin inhibition had an increased risk of CLAD and decreased overall allograft survival in the ISHLT TTX registry.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sympathetic reinnervation in cardiac transplant recipients: Prevalence, time course and association with long-term survival. 心脏移植受者的交感神经再支配：发病率、时间过程以及与长期存活的关系。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-18 DOI: 10.1016/j.healun.2024.10.009

Oliver J F Weiner,Moloy Das,Richard H Clayton,Janet M McComb,Alan Murray,Gareth Parry,Stephen W Lord

{"title":"Sympathetic reinnervation in cardiac transplant recipients: Prevalence, time course and association with long-term survival.","authors":"Oliver J F Weiner,Moloy Das,Richard H Clayton,Janet M McComb,Alan Murray,Gareth Parry,Stephen W Lord","doi":"10.1016/j.healun.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.healun.2024.10.009","url":null,"abstract":"BACKGROUNDPartial cardiac sympathetic reinnervation after cardiac transplant has been extensively investigated and evidenced. However, there have been no large-scale, long-term studies evaluating the prevalence, time-course, and association with long-term survival of sympathetic reinnervation of the heart.METHODSCardiac transplant recipients (n=232) were recruited from outpatient clinic at a single transplant centre in the United Kingdom. Participants were each tested once for the presence of sympathetic reinnervation of the sinus node using the low frequency component of power spectral analysis of heart rate variability, with a cut-off defined as 2 standard deviations above the mean for denervated participants (those tested <56 days post-transplant). Time-course was calculated based on the timing of testing post-transplant. Patients were then followed-up over a period of up to 27 years after transplant for survival analysis.RESULTSThe overall prevalence of cardiac sympathetic reinnervation in the 225 patients tested >56 days post-transplant was 64.9%. Sympathetic reinnervation primarily occurred in the first 18 months after transplant, with a plateau thereafter. The prevalence in participants tested >18 months post-transplant was 69.6%. In Kaplan-Meier survival analysis, sympathetic reinnervation was associated with significantly improved survival (Log-rank P=0.019), with a median survival time for reinnervated patients of 19.9 years compared to 14.4 years for the denervated group.CONCLUSIONSSympathetic reinnervation of the sinus node occurs mostly within 18 months of transplant, is found in 70% of cardiac transplant recipients tested >18 months post-transplant, and is associated with significantly improved long-term survival.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging Gaps in Lung Allocation: A Data-Driven Approach to Overcome Biological Disparities. 缩小肺分配差距：用数据驱动的方法克服生物差异。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-18 DOI: 10.1016/j.healun.2024.10.008

Ankit Bharat

引用次数: 0

Severe primary graft dysfunction after heart transplantation - Defining the Subtypes. 心脏移植后严重的原发性移植物功能障碍--亚型的定义。

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-18 DOI: 10.1016/j.healun.2024.10.010

Sanjay Dutta,Peter S Macdonald

引用次数: 0

Prognostic Value of Repeated Peak Oxygen Uptake Measurements in LVAD Patients. 左心室人工肾脏患者重复峰值摄氧量测量的预后价值

The Journal of Heart and Lung Transplantation Pub Date : 2024-10-17 DOI: 10.1016/j.healun.2024.10.003

William Herrik Nielsen,Mariusz K Szymanski,Kiran K Mirza,Linda W Van Laake,Thomas Schmidt,Darshan H Brahmbhatt,Filio Billia,Steven Hsu,Guy MacGowan,Djordje G Jakovljevic,Piergiuseppe Agostoni,Filippo Trombara,Ulrich P Jorde,Yogita Rochlani,Katrien Vandersmissen,Nils Reiss,Stuart D Russell,Bart Meyns,Finn Gustafsson

{"title":"Prognostic Value of Repeated Peak Oxygen Uptake Measurements in LVAD Patients.","authors":"William Herrik Nielsen,Mariusz K Szymanski,Kiran K Mirza,Linda W Van Laake,Thomas Schmidt,Darshan H Brahmbhatt,Filio Billia,Steven Hsu,Guy MacGowan,Djordje G Jakovljevic,Piergiuseppe Agostoni,Filippo Trombara,Ulrich P Jorde,Yogita Rochlani,Katrien Vandersmissen,Nils Reiss,Stuart D Russell,Bart Meyns,Finn Gustafsson","doi":"10.1016/j.healun.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.healun.2024.10.003","url":null,"abstract":"BACKGROUNDPeak oxygen uptake (pVO2) predicts mortality in heart failure patients on left ventricular assist device (LVAD) support. This follow-up of the PRO-VAD study examines the prognostic value of repeated pVO2 measurements during long-term follow-up.METHODSThis multicenter follow-up study included patients from the original PRO-VAD cohort who performed a cardiopulmonary exercise test (CPET) twice. Patients were categorized into four groups based on pVO2 levels at the two CPETs: Low at both tests, Low at the first and High at the second test, High at the first and Low at the second test, and High at both tests. Low pVO2 was defined as ≤14 mL/kg/min (or ≤12 mL/kg/min if beta-blocker tolerant), while values above these thresholds were considered High. Survival outcomes were analyzed using the Kaplan-Meier method and cause-specific Cox analysis.RESULTSThe study included 152 patients with repeated CPETs at approximately 6 and 12 months following LVAD implantation. The cohort showed slight but significant pVO2 improvement (median change: 0.4 mL/kg/min, P = 0.04). Persistently High pVO2 (76 patients) was associated with a fivefold reduction in mortality hazard (HR 0.20, P = 0.002), compared to persistently Low pVO2 (46 patients). Improvement from Low to High pVO2 (21 patients) displayed similar benefits (HR 0.21, P = 0.02).CONCLUSIONpVO2 measurements remain predictive of mortality upon reiteration in LVAD patients, with changes in pVO2 providing additional prognostic value in identifying patients with an excellent outcome on ongoing LVAD support and in identifying patients requiring further interventions.","PeriodicalId":22654,"journal":{"name":"The Journal of Heart and Lung Transplantation","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0