학술논문
Long term outcome of heart failure patients disqualified from heart transplantation.
Document Type
Academic Journal
Author
Polaska P; Heart Failure and Transplantology Department, Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.; Jerzak-Wodzynska G; Heart Failure and Transplantology Department, Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.; Smigielski W; Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.; Gajda J; Department of Statistics and Econometrics, Faculty of Economic Science, University of Warsaw, Poland.; Rozentryt P; 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.; Silesian Centre for Heart Disease, Zabrze, Poland.; Korewicki J; Heart Failure and Transplantology Department, Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.; Sobieszczanska-Malek M; Heart Failure and Transplantology Department, Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.; Zielinski T; Heart Failure and Transplantology Department, Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.; Rywik TM; Heart Failure and Transplantology Department, Cardinal Stefan Wyszynski National Institute of Cardiology, Warsaw, Poland.
Source
Publisher: Taylor & Francis Country of Publication: England NLM ID: 0370570 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1784-973X (Electronic) Linking ISSN: 00015385 NLM ISO Abbreviation: Acta Cardiol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The prognosis of patients with advanced heart failure is unfavourable. However, little is known about the survival of patients referred for heart transplantation but finally disqualified from transplantation due to contraindications. This study aimed to evaluate the prognosis of patients' disqualified from heart transplantation.
Methods: It was a retrospective study based on medical records of patients disqualified from heart transplantation.
Results: One hundred and fifty-one patients were included and 94 deaths were recorded during long-term follow-up (range 0.02-10.1 years). The survival rate at 5 years was 25%. The mean age of the studied population was 57.7 years and the majority of patients were males, 87.4%. The ischaemic aetiology (66.2%) was the most dominant aetiology of heart failure. In the Cox regression model, supervision by the specialist cardiology centre (HR 0.61; p = 0.04) and pharmacotherapy with beta-blockers (HR = 0.47; p = 0.02) positively influenced the prognosis. On the contrary, well-known heart failure risk factors like a renal failure (HR 1.59; p = 0.049), pulmonary hypertension (HR 1.55; p = 0.046), liver failure (HR 2.65; p = 0.02) were negative predictors of outcome. By Kaplan-Meier analysis, patients with other than pulmonary hypertension causes of disqualification from heart transplantation had a better survival rate, p = 0.047.
Conclusions: The prognosis of patients disqualified from heart transplantation is unfavourable. However, some of the patients experience relatively long survival. Therefore, careful clinical assessment and identification of factors influencing prognosis may improve adequate patients' qualifications for heart transplantation.
Methods: It was a retrospective study based on medical records of patients disqualified from heart transplantation.
Results: One hundred and fifty-one patients were included and 94 deaths were recorded during long-term follow-up (range 0.02-10.1 years). The survival rate at 5 years was 25%. The mean age of the studied population was 57.7 years and the majority of patients were males, 87.4%. The ischaemic aetiology (66.2%) was the most dominant aetiology of heart failure. In the Cox regression model, supervision by the specialist cardiology centre (HR 0.61; p = 0.04) and pharmacotherapy with beta-blockers (HR = 0.47; p = 0.02) positively influenced the prognosis. On the contrary, well-known heart failure risk factors like a renal failure (HR 1.59; p = 0.049), pulmonary hypertension (HR 1.55; p = 0.046), liver failure (HR 2.65; p = 0.02) were negative predictors of outcome. By Kaplan-Meier analysis, patients with other than pulmonary hypertension causes of disqualification from heart transplantation had a better survival rate, p = 0.047.
Conclusions: The prognosis of patients disqualified from heart transplantation is unfavourable. However, some of the patients experience relatively long survival. Therefore, careful clinical assessment and identification of factors influencing prognosis may improve adequate patients' qualifications for heart transplantation.