Citation

Berg K, Bjerre KP, Clemmensen TS, Løgstrup BB, Mølgaard H, et al. (2019) Heart Transplant Patients with Severe Cardiac Allograft Vasculopathy Have More Silent Ischemia and Non-Sustained Ventricular Tachycardia. Int J Transplant Res Med 5:044. doi.org/10.23937/2572-4045.1510044

Copyright

© 2019 Berg K. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL ARTICLE | OPEN ACCESS DOI: 10.23937/2572-4045.1510044

Preemptive Cautions Prior to Final İntestinal Transplantation: Four Golden Criteria in Predicting the Outcome and Long-Term Survival of Short Bowel Syndrome: Is the Remaining Bowel Length is at or above 50 Cm? Can Patient Survive Over 24 Months in Spite of any Complications? Younger Age? and Lesser Accompanying Co-Morbidity?

Katrine Berg*, Kamillla Pernille Bjerre, Tor Skibsted Clemmensen, Brian Bridal Løgstrup, Henning Mølgaard, Steen Hvitfeldt Poulsen and Hans Eiskj√¶r

Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark

Abstract

Background

The incidence of sudden cardiac death (SCD) following heart transplantation (HTx) accounts for approximately 20% of post HTx deaths. Ischemia, brady- and tachy-arrhythmias caused by rejection and cardiac allograft vasculopathy (CAV) seem related to SCD. Hence, we aimed to investigate the relation between CAV, arrhythmias and silent ischemia in long-term HTx patients.

Methods

49 HTx patients were included. Patients were CAV-classified in accordance with guidelines from International Society of Heart and Lung Transplantation. Patients were divided into predefined CAV groups (CAV 0, CAV 1, CAV 2 + 3). Incidences of arrhythmia and silent ischemia were detected by 48-hour electrocardiogram monitoring and analyzed blinded to CAV-status.

Results

Median time since transplantation was 9 years [4-14]. We observed a higher incidence of non-sustained ventricular tachycardia (NSVT) in CAV 2 + 3 patients than CAV 0 and 1 patients (p = 0.01). Likewise, isolated premature ventricular complexes (PVC) (p = 0.01) and PQ-interval prolongation (p = 0.01) were more frequent in CAV 2 + 3 patients than CAV 0 and 1 patients. Silent ischemia was only observed among CAV 3 patients (p = 0.04). We saw no significant difference in incidence of supraventricular tachycardia among CAV groups (p = 0.21). Likewise, no difference in right bundle branch block was observed (p = 0.68).

Conclusion

NSVT was associated with CAV-status in long-term HTx patients. Patients with moderate to severe CAV showed higher incidences of PVCs and PQ-interval prolongation than patients with mild or no CAV. Silent ischemia was only seen in patients with severe CAV. Nevertheless, implantation of cardioverter defibrillators (ICD) seems not warranted at this point.