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Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database

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Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database. / Wagner, Tobias; Magnussen, Christina; Bernhardt, Alexander; Smits, Jacqueline M; Steinbach, Katrin; Reichenspurner, Hermann; Kirchhof, Paulus; Grahn, Hanno.

In: FRONT CARDIOVASC MED, Vol. 9, 1036547, 2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Wagner, T, Magnussen, C, Bernhardt, A, Smits, JM, Steinbach, K, Reichenspurner, H, Kirchhof, P & Grahn, H 2022, 'Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database', FRONT CARDIOVASC MED, vol. 9, 1036547. https://doi.org/10.3389/fcvm.2022.1036547

APA

Wagner, T., Magnussen, C., Bernhardt, A., Smits, J. M., Steinbach, K., Reichenspurner, H., Kirchhof, P., & Grahn, H. (2022). Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database. FRONT CARDIOVASC MED, 9, [1036547]. https://doi.org/10.3389/fcvm.2022.1036547

Vancouver

Wagner T, Magnussen C, Bernhardt A, Smits JM, Steinbach K, Reichenspurner H et al. Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database. FRONT CARDIOVASC MED. 2022;9. 1036547. https://doi.org/10.3389/fcvm.2022.1036547

Bibtex

@article{59490c4f497c49efba4942ea395965d3,
title = "Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database",
abstract = "BACKGROUND: Predicting complications associated with pulmonary hypertension (PH) after cardiac transplantation is an important factor when considering cardiac transplantation. The transpulmonary gradient (TPG) is recommended to quantify PH in transplant candidates. Nonetheless, PH remains a common driver of mortality. The diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) can differentiate post- from combined pre- and post-capillary PH and may improve estimation of PH-associated risks. We used a large European cohort of transplant candidates to assess whether the pulmonary pulsatility index (PAPi), improves prediction of graft failure and mortality compared to DPG and PVR.METHODS: Out of all patients undergoing heart transplantation between 2009 and 2019 in Eurotransplant member states (n = 10,465), we analyzed the impact of PH (mPAP > 25 mmHg) and right heart catheter hemodynamic data on graft failure and mortality within 1-5 years.RESULTS: In 1,407 heart transplant patients with PH (79% male, median age 54 years, IQR 39-69 years), the median PVR was 2.5 WU (IQR 1.6 WU) with a median mPAP (pulmonary arterial pressure) of 32 mmHg (IQR 9 mmHg). Patients with low (< 3 mmHg) DPG had a better 5 year survival than those with higher DPG (log rank p = 0.023). TPG, mPAP, PAPi, and PVR did not improve prediction of survival. Low PAPi (OR = 2.24, p < 0.001) and high PVR (OR = 2.12, p = 0.005) were associated with graft failure.CONCLUSION: PAPI and PVR are associated with graft failure in patients with PH undergoing cardiac transplantation. DPG is associated with survival in this cohort.",
author = "Tobias Wagner and Christina Magnussen and Alexander Bernhardt and Smits, {Jacqueline M} and Katrin Steinbach and Hermann Reichenspurner and Paulus Kirchhof and Hanno Grahn",
note = "Copyright {\textcopyright} 2022 Wagner, Magnussen, Bernhardt, Smits, Steinbach, Reichenspurner, Kirchhof and Grahn.",
year = "2022",
doi = "10.3389/fcvm.2022.1036547",
language = "English",
volume = "9",
journal = "FRONT CARDIOVASC MED",
issn = "2297-055X",
publisher = "Frontiers Media S. A.",

}

RIS

TY - JOUR

T1 - Impact of diastolic pulmonary gradient and pulmonary artery pulse index on outcomes in heart transplant patients-Results from the Eurotransplant database

AU - Wagner, Tobias

AU - Magnussen, Christina

AU - Bernhardt, Alexander

AU - Smits, Jacqueline M

AU - Steinbach, Katrin

AU - Reichenspurner, Hermann

AU - Kirchhof, Paulus

AU - Grahn, Hanno

N1 - Copyright © 2022 Wagner, Magnussen, Bernhardt, Smits, Steinbach, Reichenspurner, Kirchhof and Grahn.

PY - 2022

Y1 - 2022

N2 - BACKGROUND: Predicting complications associated with pulmonary hypertension (PH) after cardiac transplantation is an important factor when considering cardiac transplantation. The transpulmonary gradient (TPG) is recommended to quantify PH in transplant candidates. Nonetheless, PH remains a common driver of mortality. The diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) can differentiate post- from combined pre- and post-capillary PH and may improve estimation of PH-associated risks. We used a large European cohort of transplant candidates to assess whether the pulmonary pulsatility index (PAPi), improves prediction of graft failure and mortality compared to DPG and PVR.METHODS: Out of all patients undergoing heart transplantation between 2009 and 2019 in Eurotransplant member states (n = 10,465), we analyzed the impact of PH (mPAP > 25 mmHg) and right heart catheter hemodynamic data on graft failure and mortality within 1-5 years.RESULTS: In 1,407 heart transplant patients with PH (79% male, median age 54 years, IQR 39-69 years), the median PVR was 2.5 WU (IQR 1.6 WU) with a median mPAP (pulmonary arterial pressure) of 32 mmHg (IQR 9 mmHg). Patients with low (< 3 mmHg) DPG had a better 5 year survival than those with higher DPG (log rank p = 0.023). TPG, mPAP, PAPi, and PVR did not improve prediction of survival. Low PAPi (OR = 2.24, p < 0.001) and high PVR (OR = 2.12, p = 0.005) were associated with graft failure.CONCLUSION: PAPI and PVR are associated with graft failure in patients with PH undergoing cardiac transplantation. DPG is associated with survival in this cohort.

AB - BACKGROUND: Predicting complications associated with pulmonary hypertension (PH) after cardiac transplantation is an important factor when considering cardiac transplantation. The transpulmonary gradient (TPG) is recommended to quantify PH in transplant candidates. Nonetheless, PH remains a common driver of mortality. The diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) can differentiate post- from combined pre- and post-capillary PH and may improve estimation of PH-associated risks. We used a large European cohort of transplant candidates to assess whether the pulmonary pulsatility index (PAPi), improves prediction of graft failure and mortality compared to DPG and PVR.METHODS: Out of all patients undergoing heart transplantation between 2009 and 2019 in Eurotransplant member states (n = 10,465), we analyzed the impact of PH (mPAP > 25 mmHg) and right heart catheter hemodynamic data on graft failure and mortality within 1-5 years.RESULTS: In 1,407 heart transplant patients with PH (79% male, median age 54 years, IQR 39-69 years), the median PVR was 2.5 WU (IQR 1.6 WU) with a median mPAP (pulmonary arterial pressure) of 32 mmHg (IQR 9 mmHg). Patients with low (< 3 mmHg) DPG had a better 5 year survival than those with higher DPG (log rank p = 0.023). TPG, mPAP, PAPi, and PVR did not improve prediction of survival. Low PAPi (OR = 2.24, p < 0.001) and high PVR (OR = 2.12, p = 0.005) were associated with graft failure.CONCLUSION: PAPI and PVR are associated with graft failure in patients with PH undergoing cardiac transplantation. DPG is associated with survival in this cohort.

U2 - 10.3389/fcvm.2022.1036547

DO - 10.3389/fcvm.2022.1036547

M3 - SCORING: Journal article

C2 - 36588552

VL - 9

JO - FRONT CARDIOVASC MED

JF - FRONT CARDIOVASC MED

SN - 2297-055X

M1 - 1036547

ER -