Heart transplantation in hypertrophic cardiomyopathy

被引:49
作者
Biagini, Elena [1 ,2 ]
Spirito, Paolo [3 ]
Leone, Ornella [4 ]
Picchio, Fernando M. [1 ,5 ]
Coccolo, Fabio [1 ,2 ]
Ragni, Luca [1 ,2 ,5 ]
Lofiego, Carla [1 ,2 ]
Grigioni, Francesco [1 ,2 ]
Potena, Luciano [1 ,2 ]
Rocchi, Guido [1 ,2 ]
Bacchi-Reggiarn, Letizia [1 ,2 ]
Boriani, Giuseppe [1 ,2 ]
Prandstraller, Daniela [1 ,5 ]
Arbustini, Eloisa [6 ]
Branzi, Angelo [1 ,2 ]
Rapezzi, Claudio [1 ,2 ]
机构
[1] Univ Bologna, Inst Cardiol, Bologna, Italy
[2] St Orsola Marcello Malpighi Hosp, Bologna, Italy
[3] Galliera Hosp, Inst Cardiol, Genoa, Italy
[4] St Orsola Marcello Malpighi Hosp, Dept Pathol, Bologna, Italy
[5] Univ Bologna, Pediat Cardiol & Adult Congenital Unit, Bologna, Italy
[6] Policlin San Matteo, IRCCS, Ctr Inherited Cardiovasc Dis, I-27100 Pavia, Italy
关键词
D O I
10.1016/j.amjcard.2007.09.085
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heart transplantation (HT) is the sole therapeutic option for selected patients with hypertrophic cardiomyopathy (HQ and refractory heart failure. However, the results of HT have not been systematically investigated in HC. We assessed the pathophysiologic profile of HT candidates and the outcome after transplantation in 307 patients with HC consecutively evaluated at our tertiary referral center from 1987 to 2005; follow-up was 9.9+8.2 years. Outcome of recipients with HC was compared with that of 141 patients who underwent transplantation for idiopathic dilated cardiomyopathy at our center over the same period. Of 21 patients with HC who entered the transplantation list, 20 had end-stage evolution with systolic dysfunction and 1 had an extremely small left ventricular cavity with impaired filling and recurrent cardiogenic shock during paroxysmal atrial fibrillation. Of 33 study patients with HC who showed end-stage evolution during follow-up, the 23 who were included on the waiting list or died from refractory heart failure (2 patients) were significantly younger than the 10 patients who remained clinically stable (37 +/- 14 vs 57 +/- 17 years, p = 0.004). Of the 21 HT candidates, 18 underwent transplantation during follow-up. In heart transplant recipients, 7-year survival rate was 94% and not different from that of the 141 patients who received transplants for idiopathic dilated cardiomyopathy (p = 0.66). In conclusion, long-term outcome after HT in patients with HC is favorable and similar to that of patients with idiopathic dilated cardiomyopathy. In patients with end-stage HC, young age is associated with more rapid progression to refractory heart failure. (c) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:387 / 392
页数:6
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