ArticleArchivos de cardiologia de Mexico2022
The right ventricle of transplanted hearts at 2,640 meters above sea level. A latin-american experience.
Article in Archivos de cardiologia de Mexico, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHigh-altitude cardiovascular adaptations increase lung pressure. This effect on the right ventricle (RV) of transplanted hearts at altitudes above 2,500 meters above sea level (masl) has not been described.
objectiveThe objective of the study was to describe echocardiography RV behavior in the immediate post-operative period (Days 1-7 post-Heart transplant [HTx]), 3, 6, 12, and 24 months after HTx in patients at 2640 masl.
methodsHistorical cohort of HTx patients in the period between 2005 and 2019, in a hospital located in Bogotá, Colombia. Socio-demographic, clinical, and echocardiographic evaluation data of the RV at 5 follow-up moments were analyzed.
results91 patients underwent HTx, 64% remained at a height > 2500 masl in the post-operative period. Transthoracic echo was available in 37 patients (40.6%). Right ventricular dysfunction was found in 95% of patients, which was predominantly moderate (43%), with improvement 3 months after transplant. The immediate post-operative Tricuspid annular plane systolic excursion was 8.9 ± 4.9 mm, with recovery from the 3rd post-operative month (15.1 ± 3.6 mm) and without significant changes in month 24 (15.8 ± 4.9 mm). Immediate post-operative systolic pulmonary artery pressure (sPAP) was 39.2 ± 8.2 mmHg, showing a decrease at 24 post-operative months (31.0 ± 5.0 mmHg). The 5-year survival was 78% Confidence Interval 95% 60-85.
conclusionAfter HTx, most patients present right ventricular dysfunction, improving at the 3rd month of transplant. There were no significant differences between patients living at more than 2500 masl and < 2500 masl.
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