TOPLINE

Among adults with pulmonary vascular resistance within transplant-acceptable limits who underwent an orthotopic heart transplant, pulmonary artery systolic pressure (PASP) > 50 mm Hg was associated with modestly lower survival through 20 years, as per a brief report published in JACC: Heart Failure. 

METHODOLOGY

• Researchers used data from a transplant registry to assess whether elevated PASP at the time of an orthotopic heart transplant was associated with posttransplant outcomes. 
• They included 42,847 patients (median age, 55 years; 76% men) who underwent a single-organ orthotopic heart transplant between 1987 and 2022. 
• All patients had pulmonary vascular resistance below the acceptable threshold for a transplant. 
• Overall, 16% of the patients had elevated PASP, which was defined as PASP > 50 mm Hg. 
• The primary outcomes were short-term and long-term survival after an orthotopic heart transplant. The incidence of graft failure was the secondary outcome. 

TAKEAWAY

• Patients with elevated PASP had modestly lower survival than those with nonelevated PASP at 1 year (88.1% vs 90.4%); the difference was persistent at 5, 10, and 20 years (log-rank P < .001). 
• No association was found between elevated PASP and graft failure. 

IN PRACTICE

"[The study] findings suggest that elevated PASP in the setting of acceptable PVR [pulmonary vascular resistance] should not, in isolation, preclude transplant candidacy. Greater attention to comorbidity burden, renal dysfunction, and mechanical support strategy may have more substantial implications for improving long-term outcomes," the researchers wrote.

SOURCE

The study was led by Efeose Airewele, MD, of Northwestern University in Chicago. It was published online on October 28 as a Brief Report in JACC: Heart Failure.

LIMITATIONS

The study relied on registry data, which might contain reporting errors or missing information. PASP was assessed as a categorical measure; therefore, dynamic changes were not evaluated. Hemodynamics after transplant were not analyzed.

DISCLOSURES

The study did not receive any external funding. The authors reported having no relevant relationships to disclose.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.