Pre-operative pulmonary artery pulsatility index does not predict mortality post-cardiac transplantation.

Bart, N; Hungerford, S; Emmanuel, S; Kotlyar, E; Keogh, A; MacDonald, P; Muller, D; Hayward, C

Pre-operative pulmonary artery pulsatility index does not predict mortality post-cardiac transplantation.

Bart, N Hungerford, S Emmanuel, S Kotlyar, E Keogh, A MacDonald, P Muller, D Hayward, C

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: ESC Heart Fail, 2023, 10, (3), pp. 1980-1986
Issue Date:: 2023-06

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Field	Value	Language
dc.contributor.author	Bart, N
dc.contributor.author	Hungerford, S
dc.contributor.author	Emmanuel, S
dc.contributor.author	Kotlyar, E
dc.contributor.author	Keogh, A
dc.contributor.author	MacDonald, P
dc.contributor.author	Muller, D
dc.contributor.author	Hayward, C
dc.date.accessioned	2024-04-09T22:25:48Z
dc.date.available	2022-10-28
dc.date.available	2024-04-09T22:25:48Z
dc.date.issued	2023-06
dc.identifier.citation	ESC Heart Fail, 2023, 10, (3), pp. 1980-1986
dc.identifier.issn	2055-5822
dc.identifier.issn	2055-5822
dc.identifier.uri	http://hdl.handle.net/10453/177628
dc.description.abstract	AIMS: The pulmonary artery pulsatility index (PAPi) is a novel haemodynamic marker that has previously been shown to predict right ventricular dysfunction and mortality in patients with pulmonary hypertension and advanced heart failure. Utility of the PAPi in predicting outcomes post-cardiac transplantation is unknown. The aim of this study was to compare the prognostic significance of PAPi against pulmonary vascular resistance (PVR) for the predication of morbidity and all-cause mortality post-transplantation. METHODS AND RESULTS: All patients who underwent cardiac transplantation over a 6 year period were studied. Pre-operative right heart catheter data was obtained. The PAPi was calculated as follows: (systolic pulmonary artery pressure [sPAP] - diastolic pulmonary artery pressure [dPAP])/right atrial (RA) pressure. One hundred fifty-eight patients with a mean age of 49 ± 14 years were studied (43 with a pre-transplant left ventricular assist device [LVAD]). Three patients were excluded due to missing data. In the non-LVAD group, there was no significant difference in PAPi or PVR, nor was there any association with post-operative outcome (including stratification by natural history sub-type; all P > 0.05). In the LVAD group, there was no association with PAPi and post-operative outcome; however, PVR was predictive of post-operative mortality (mortality: 2.8 ± 1.3 WU vs. alive: 1.7 ± 0.7 WU; P = 0.005). CONCLUSIONS: The PAPi was not able to discriminate mortality outcomes for patients post-cardiac transplantation. Pulmonary vascular resistance remains a marker of mortality in an LVAD cohort bridged to transplant (central illustration).
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	ESC Heart Fail
dc.relation.isbasedon	10.1002/ehf2.14226
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology
dc.subject.classification	3201 Cardiovascular medicine and haematology
dc.subject.mesh	Humans
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Pulmonary Artery
dc.subject.mesh	Heart Transplantation
dc.subject.mesh	Prognosis
dc.subject.mesh	Hemodynamics
dc.subject.mesh	Vascular Resistance
dc.subject.mesh	Pulmonary Artery
dc.subject.mesh	Humans
dc.subject.mesh	Prognosis
dc.subject.mesh	Heart Transplantation
dc.subject.mesh	Vascular Resistance
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Hemodynamics
dc.subject.mesh	Humans
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Pulmonary Artery
dc.subject.mesh	Heart Transplantation
dc.subject.mesh	Prognosis
dc.subject.mesh	Hemodynamics
dc.subject.mesh	Vascular Resistance
dc.title	Pre-operative pulmonary artery pulsatility index does not predict mortality post-cardiac transplantation.
dc.type	Journal Article
utslib.citation.volume	10
utslib.location.activity	England
utslib.for	1102 Cardiorespiratory Medicine and Haematology
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
utslib.copyright.status	open_access	*
dc.date.updated	2024-04-09T22:25:46Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	10
utslib.citation.issue	3

Abstract:

AIMS: The pulmonary artery pulsatility index (PAPi) is a novel haemodynamic marker that has previously been shown to predict right ventricular dysfunction and mortality in patients with pulmonary hypertension and advanced heart failure. Utility of the PAPi in predicting outcomes post-cardiac transplantation is unknown. The aim of this study was to compare the prognostic significance of PAPi against pulmonary vascular resistance (PVR) for the predication of morbidity and all-cause mortality post-transplantation. METHODS AND RESULTS: All patients who underwent cardiac transplantation over a 6 year period were studied. Pre-operative right heart catheter data was obtained. The PAPi was calculated as follows: (systolic pulmonary artery pressure [sPAP] - diastolic pulmonary artery pressure [dPAP])/right atrial (RA) pressure. One hundred fifty-eight patients with a mean age of 49 ± 14 years were studied (43 with a pre-transplant left ventricular assist device [LVAD]). Three patients were excluded due to missing data. In the non-LVAD group, there was no significant difference in PAPi or PVR, nor was there any association with post-operative outcome (including stratification by natural history sub-type; all P > 0.05). In the LVAD group, there was no association with PAPi and post-operative outcome; however, PVR was predictive of post-operative mortality (mortality: 2.8 ± 1.3 WU vs. alive: 1.7 ± 0.7 WU; P = 0.005). CONCLUSIONS: The PAPi was not able to discriminate mortality outcomes for patients post-cardiac transplantation. Pulmonary vascular resistance remains a marker of mortality in an LVAD cohort bridged to transplant (central illustration).

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http://hdl.handle.net/10453/177628