Gungor H, Oguz E, Ayik M F, Ertugay S, Engin C, Yagdi T, Nalbantgil S, Zoghi M, Ozbaran M
Department of Cardiology, Mus State Hospital, Mus, Turkey.
Transplant Proc. 2011 Dec;43(10):3847-50. doi: 10.1016/j.transproceed.2011.09.073.
We retrospectively analyzed our data to compare preoperative demographic, laboratory, echocardiographic, hemodynamic findings mortality and survival rates of heart transplantation patients with ischemic (ICM) and idiopathic dilated (IDCM) cardiomyopathy.
The data of 144 patients transplanted from February 1998 to January 2011 were analyzed. 38 patients with ischemic ICM and 86 patients with IDCM were compared.
Recipient age, preoperative creatinine, recipient body mass index, intraoperative cross-clamp time, donor male sex ratio, recipient male sex ratio, hyperlipidemia ratio, and previous nitrate use were significantly higher and left ventricular end systolic diameter significantly lower in patients with ICM. Major causes of death after heart transplantation were infections (31.9%), right ventricle failure (14.8%), and sudden cardiac death (14.8%). Causes of death were not different between the groups. Overall mortality in the entire population was 37.9% (47/124), and it was not different between the groups (39.5% vs 37.2%; P=.48). Early mortality (<30 days) rate was 11.2% (14/124), late mortality rate was 26.6% (33/124), and no statistically significant difference was observed between the groups. Survival analysis showed that ICM patients were not associated with worse survival compared with IDCM (71.1% vs 81.1% after 1 year, 68.1% vs 73.0% at 2 years, and 54.2% vs 62.3% at 5 years; log rank=0.57). Multivariate analysis showed that the only predictor of mortality was preoperative urea level and that heart failure etiology was not a predictor of this end point.
Patients with ICM had similar survival and mortality rate compared with IDCM.
我们回顾性分析了我们的数据，以比较缺血性心肌病（ICM）和特发性扩张型心肌病（IDCM）患者心脏移植术前的人口统计学、实验室检查、超声心动图、血流动力学结果、死亡率和生存率。
分析了1998年2月至2011年1月期间144例接受移植患者的数据。比较了38例缺血性ICM患者和86例IDCM患者。
ICM患者的受者年龄、术前肌酐、受者体重指数、术中主动脉阻断时间、供者男性比例、受者男性比例、高脂血症比例和既往硝酸盐使用情况显著更高，而左心室收缩末期直径显著更低。心脏移植术后主要死亡原因是感染（31.9%）、右心室衰竭（14.8%）和心源性猝死（14.8%）。两组间死亡原因无差异。整个人群的总死亡率为37.9%（47/124），两组间无差异（39.5%对37.2%；P = 0.48）。早期死亡率（<30天）为11.2%（14/124），晚期死亡率为26.6%（33/124），两组间未观察到统计学显著差异。生存分析表明，与IDCM相比，ICM患者的生存率并无更差（1年后分别为71.1%对81.1%，2年后分别为68.1%对73.0%，5年后分别为54.2%对62.3%；对数秩检验=0.57）。多因素分析表明，死亡率的唯一预测因素是术前尿素水平，而心力衰竭病因不是该终点的预测因素。
与IDCM相比，ICM患者的生存率和死亡率相似。
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