Reverse Ventricular Remodeling and Improved Ventricular Compliance After Heart Transplantation in Infants and Young Children

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• 作者：Kanwal M. Farooqi (1)
  Leo Lopez (2)
  Robert H. Pass (2)
  Daphne T. Hsu (2)
  Jacqueline M. Lamour (2)
  
• 关键词：Pediatric heart transplantation ; Cardiac transplant growth ; Cardiac transplant ventricular compliance
• 刊名：Pediatric Cardiology
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：35
• 期：6
• 页码：922-927
• 全文大小：291 KB
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• 作者单位：Kanwal M. Farooqi (1)
  Leo Lopez (2)
  Robert H. Pass (2)
  Daphne T. Hsu (2)
  Jacqueline M. Lamour (2)
  
  1. Division of Pediatric Cardiology, Department of Pediatrics, The Mount Sinai Medical Center, New York, NY, USA
  2. Division of Pediatric Cardiology, Department of Pediatrics, The Children’s Hospital at Montefiore/Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Rosenthal 1, Bronx, NY, 10467, USA
  
• ISSN：1432-1971

文摘

After heart transplantation (HT) in infants and young children, environmental and intrinsic factors may lead to changes in the geometry and compliance of the donor heart. Serial demographic, clinical, hemodynamic, and echocardiographic data were obtained from HT recipients younger than 4?years of age. Echocardiographic chamber measurement z-scores were compared using recipient body surface area from the time of HT to 1?week, 3?months, and last follow-up visit. Left ventricular end-diastolic volume (LVEDV) z-scores were correlated with pulmonary capillary wedge pressure (PCWP) at each time point. Heart transplantation was performed for 13 children between March 2009 and December 2012, 9 of whom (69?%) were boys. The median age at HT was 8?months (range, 4-3?months), and the mean follow-up period was 13?±?7?months. Left ventricular end-diastolic dimension z-scores decreased significantly (p?=?0.03) between HT and 1?week, then increased from 1?week to 3 and 12?months. (?.32?±?1.7, ?.71?±?1.8, 0.41?±?2.1, 0.79?±?2.3, respectively). A positive relationship (R 2?=?0.48) between the LVEDV z-score and PCPW was present at the last follow-up visit. For infants and young children, the allograft demonstrates appropriate growth by 1?year after HT. Left ventricular compliance improves over time.