Long-term myocardial function after heart transplantation

Thorac Cardiovasc Surg. 1993 Jun;41(3):156-62. doi: 10.1055/s-2007-1013845.


With an increasing number of heart transplantations and an improved survival rate a characterization of the long-term hemodynamic profile of the transplanted heart is necessary. 222 cardiac catheterizations were performed in 71 heart recipients under cyclosporine A immunosuppression during a 7-year follow-up after transplantation. Hemodynamic evaluation revealed a non-progressive arterial hypertension due to an increased systemic vascular resistance, leading to a mild increase of left-ventricular chamber stiffness. Parameters of systolic myocardial function were found to be normal and did not deteriorate during the 7 year period. The prevalence of allograft coronary angiopathy increased from 13% one year to 54% five years after transplantation. Myocardial function was neither adversely influenced by the presence of coronary angiopathy nor by the number or severity of former rejection episodes. Unchanged annual pressure-volume loops excluded the development of a dilated or restrictive posttransplantation cardiomyopathy. Thus, not the myocardial function, but the coronary angiopathy represents the most critical cardiac long-term problem after transplantation.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Biopsy
  • Cardiac Catheterization
  • Child
  • Endocardium / pathology
  • Follow-Up Studies
  • Germany, West / epidemiology
  • Graft Rejection / epidemiology
  • Graft Rejection / mortality
  • Graft Rejection / physiopathology
  • Heart / physiopathology*
  • Heart Transplantation / mortality
  • Heart Transplantation / physiology*
  • Heart Transplantation / statistics & numerical data
  • Hemodynamics
  • Humans
  • Middle Aged
  • Time Factors