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Incidence of right ventricular dysfunction in adult patients submitted to cardiac transplantation: evaluation according to reversible pulmonary hypertension prior to transplantation

Grant number: 18/00903-4
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): June 01, 2018
Effective date (End): May 31, 2020
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Fabiana Goulart Marcondes Braga
Grantee:Mariana Moreira Lensi
Home Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Cardiac transplantation remains the treatment of choice for patients with refractory heart failure. Over time, pressure and volume overload can lead to pulmonary vascular remodeling and a significant increase in pulmonary circulation resistance in patients with left heart failure leading to a worse prognosis. Due to the risks of postoperative right ventricular failure, the presence of irreversible pre-transplantation pulmonary hypertension (PH) is a contraindication for transplantation. In many patients it is possible to reverse the major component of secondary PH by infusion of vasodilators. Considering the use of measures to reduce the risk of RV dysfunction such as vasodilators, patients who present PH reversibility are generally released for transplantation. However, it is not known in our population whether the presence of PH, although reversible, may have some postoperative implication in the incidence of RV dysfunction and early post-transplant mortality.Objective: To evaluate the incidence of right ventricular dysfunction in adult patients submitted to heart transplantation at the Heart Institute, from 2013 to 2016, according to the PH reversible presence.Method: Retrospective observational study. Pre-transplantation data and the first 15 days after transplantation will be evaluated, aiming to analyze the incidence of right ventricular dysfunction. Two groups for data analysis: group 1 - no PH and group 2 - reversible PH. The incidence of moderate to severe right ventricular dysfunction in the postoperative period will be assessed and compared between the two groups.

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