Prognosis of medically treated patients referred for cardiac transplantation
Objectives: To assess prognosis and factors influencing survival of transplant candidates in whom continued medial therapy was recommended in comparison to that of immediately listed patients. Methods: Retrospective analysis of clinical, echocardiographic and hemodynamic data as related to survival...
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| Veröffentlicht in: | International journal of cardiology 1998-03, Vol.64 (1), p.75-81 |
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| container_title | International journal of cardiology |
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| creator | Oechslin, Erwin Brunner-LaRocca, Hans Peter Solt, Gabor Sütsch, Gabor Jenni, Rolf Gallino, Augusto Mayer, Kurt Vogt, Paul Künzli, Andreas Turina, Marko Kiowski, Wolfgang |
| description | Objectives: To assess prognosis and factors influencing survival of transplant candidates in whom continued medial therapy was recommended in comparison to that of immediately listed patients.
Methods: Retrospective analysis of clinical, echocardiographic and hemodynamic data as related to survival or listing for transplantation of medically treated transplant candidates.
Patients: 160 patients considered `too well' for cardiac transplantation and 133 patients immediately listed for transplantation.
Results: Forty-one of the medically treated patients deteriorated clinically and were listed after 10.7±12.3 months after initial evaluation. Mid-term prognosis (2 years) of patients never listed was comparable to that of immediately listed patients (74% vs. 70%) but long-term prognosis (5 years) was worse (41% vs. 54%, p |
| doi_str_mv | 10.1016/S0167-5273(98)00007-2 |
| format | Article |
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Methods: Retrospective analysis of clinical, echocardiographic and hemodynamic data as related to survival or listing for transplantation of medically treated transplant candidates.
Patients: 160 patients considered `too well' for cardiac transplantation and 133 patients immediately listed for transplantation.
Results: Forty-one of the medically treated patients deteriorated clinically and were listed after 10.7±12.3 months after initial evaluation. Mid-term prognosis (2 years) of patients never listed was comparable to that of immediately listed patients (74% vs. 70%) but long-term prognosis (5 years) was worse (41% vs. 54%, p<0.001). Cardiothoracic ratio and pulmonary capillary wedge pressure were independent predictors of survival (multivariate analysis) in patients whose NYHA class and physical working capacity improved and cardiothoracic ratio decreased significantly after adjustment of medical therapy.
Conclusions: Mid-term prognosis of selected patients considered `too well' for transplantion is comparable to patients immediately listed. Lower left ventricular filling pressures, smaller hearts on chest X-ray on initial evaluation, and improvement of symptoms during follow up may identify a subgroup of patients who do well on optimized therapy.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/S0167-5273(98)00007-2</identifier><identifier>PMID: 9579819</identifier><identifier>CODEN: IJCDD5</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Actuarial Analysis ; Adult ; Biological and medical sciences ; Cardiology. Vascular system ; Cause of Death ; Confidence Intervals ; Congestive heart failure ; Disease Progression ; Echocardiography ; Female ; Follow-Up Studies ; Heart ; Heart Failure - diagnosis ; Heart Failure - mortality ; Heart Failure - therapy ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart transplantation ; Heart Transplantation - statistics & numerical data ; Hemodynamics ; Humans ; Male ; Medical sciences ; Medical therapy ; Middle Aged ; Patient Selection ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Survival Rate</subject><ispartof>International journal of cardiology, 1998-03, Vol.64 (1), p.75-81</ispartof><rights>1998 Elsevier Science Ireland Ltd</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-1439804b22b50388b45b23320d519f2f30b8fc8973f7c520503c332ac0ca943c3</citedby><cites>FETCH-LOGICAL-c389t-1439804b22b50388b45b23320d519f2f30b8fc8973f7c520503c332ac0ca943c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0167-5273(98)00007-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2198519$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9579819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oechslin, Erwin</creatorcontrib><creatorcontrib>Brunner-LaRocca, Hans Peter</creatorcontrib><creatorcontrib>Solt, Gabor</creatorcontrib><creatorcontrib>Sütsch, Gabor</creatorcontrib><creatorcontrib>Jenni, Rolf</creatorcontrib><creatorcontrib>Gallino, Augusto</creatorcontrib><creatorcontrib>Mayer, Kurt</creatorcontrib><creatorcontrib>Vogt, Paul</creatorcontrib><creatorcontrib>Künzli, Andreas</creatorcontrib><creatorcontrib>Turina, Marko</creatorcontrib><creatorcontrib>Kiowski, Wolfgang</creatorcontrib><title>Prognosis of medically treated patients referred for cardiac transplantation</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Objectives: To assess prognosis and factors influencing survival of transplant candidates in whom continued medial therapy was recommended in comparison to that of immediately listed patients.
Methods: Retrospective analysis of clinical, echocardiographic and hemodynamic data as related to survival or listing for transplantation of medically treated transplant candidates.
Patients: 160 patients considered `too well' for cardiac transplantation and 133 patients immediately listed for transplantation.
Results: Forty-one of the medically treated patients deteriorated clinically and were listed after 10.7±12.3 months after initial evaluation. Mid-term prognosis (2 years) of patients never listed was comparable to that of immediately listed patients (74% vs. 70%) but long-term prognosis (5 years) was worse (41% vs. 54%, p<0.001). Cardiothoracic ratio and pulmonary capillary wedge pressure were independent predictors of survival (multivariate analysis) in patients whose NYHA class and physical working capacity improved and cardiothoracic ratio decreased significantly after adjustment of medical therapy.
Conclusions: Mid-term prognosis of selected patients considered `too well' for transplantion is comparable to patients immediately listed. Lower left ventricular filling pressures, smaller hearts on chest X-ray on initial evaluation, and improvement of symptoms during follow up may identify a subgroup of patients who do well on optimized therapy.</description><subject>Actuarial Analysis</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cause of Death</subject><subject>Confidence Intervals</subject><subject>Congestive heart failure</subject><subject>Disease Progression</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - therapy</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart transplantation</subject><subject>Heart Transplantation - statistics & numerical data</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical therapy</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtLAzEQgIMotVZ_QmEPInpYzWNjkpNI8QUFBfUcstlEIttNTbZC_73TdunVHJKQ-WYy8yE0JfiaYHJ78w6bKDkV7FLJKwxLlPQAjYkUVUkErw7ReI8co5Ocv4GplJIjNFJcKEnUGM3fUvzqYg65iL5YuCZY07brok_O9K4plqYPrutzkZx3KcGLj6mwJjXBWKBMl5et6XrAYneKjrxpszsbzgn6fHz4mD2X89enl9n9vLRMqr4kFVMSVzWlNcdMyrriNWWM4oYT5alnuJbeSiWYF5ZTDJCFsLHYGlXBfYIudnWXKf6sXO71ImTrWmjExVXWMBuTQjIA-Q60KeYMI-hlCguT1ppgvbGotxb1RpFWUm8tagp50-GDVQ1O9lmDNoifD3GTwZcHDTbkPUaJknyL3e0wBzJ-g0s6W7BpwXJyttdNDP808gdeQY3v</recordid><startdate>19980313</startdate><enddate>19980313</enddate><creator>Oechslin, Erwin</creator><creator>Brunner-LaRocca, Hans Peter</creator><creator>Solt, Gabor</creator><creator>Sütsch, Gabor</creator><creator>Jenni, Rolf</creator><creator>Gallino, Augusto</creator><creator>Mayer, Kurt</creator><creator>Vogt, Paul</creator><creator>Künzli, Andreas</creator><creator>Turina, Marko</creator><creator>Kiowski, Wolfgang</creator><general>Elsevier Ireland Ltd</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980313</creationdate><title>Prognosis of medically treated patients referred for cardiac transplantation</title><author>Oechslin, Erwin ; Brunner-LaRocca, Hans Peter ; Solt, Gabor ; Sütsch, Gabor ; Jenni, Rolf ; Gallino, Augusto ; Mayer, Kurt ; Vogt, Paul ; Künzli, Andreas ; Turina, Marko ; Kiowski, Wolfgang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-1439804b22b50388b45b23320d519f2f30b8fc8973f7c520503c332ac0ca943c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Actuarial Analysis</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cause of Death</topic><topic>Confidence Intervals</topic><topic>Congestive heart failure</topic><topic>Disease Progression</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - therapy</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart transplantation</topic><topic>Heart Transplantation - statistics & numerical data</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical therapy</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oechslin, Erwin</creatorcontrib><creatorcontrib>Brunner-LaRocca, Hans Peter</creatorcontrib><creatorcontrib>Solt, Gabor</creatorcontrib><creatorcontrib>Sütsch, Gabor</creatorcontrib><creatorcontrib>Jenni, Rolf</creatorcontrib><creatorcontrib>Gallino, Augusto</creatorcontrib><creatorcontrib>Mayer, Kurt</creatorcontrib><creatorcontrib>Vogt, Paul</creatorcontrib><creatorcontrib>Künzli, Andreas</creatorcontrib><creatorcontrib>Turina, Marko</creatorcontrib><creatorcontrib>Kiowski, Wolfgang</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oechslin, Erwin</au><au>Brunner-LaRocca, Hans Peter</au><au>Solt, Gabor</au><au>Sütsch, Gabor</au><au>Jenni, Rolf</au><au>Gallino, Augusto</au><au>Mayer, Kurt</au><au>Vogt, Paul</au><au>Künzli, Andreas</au><au>Turina, Marko</au><au>Kiowski, Wolfgang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognosis of medically treated patients referred for cardiac transplantation</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>1998-03-13</date><risdate>1998</risdate><volume>64</volume><issue>1</issue><spage>75</spage><epage>81</epage><pages>75-81</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><coden>IJCDD5</coden><abstract>Objectives: To assess prognosis and factors influencing survival of transplant candidates in whom continued medial therapy was recommended in comparison to that of immediately listed patients.
Methods: Retrospective analysis of clinical, echocardiographic and hemodynamic data as related to survival or listing for transplantation of medically treated transplant candidates.
Patients: 160 patients considered `too well' for cardiac transplantation and 133 patients immediately listed for transplantation.
Results: Forty-one of the medically treated patients deteriorated clinically and were listed after 10.7±12.3 months after initial evaluation. Mid-term prognosis (2 years) of patients never listed was comparable to that of immediately listed patients (74% vs. 70%) but long-term prognosis (5 years) was worse (41% vs. 54%, p<0.001). Cardiothoracic ratio and pulmonary capillary wedge pressure were independent predictors of survival (multivariate analysis) in patients whose NYHA class and physical working capacity improved and cardiothoracic ratio decreased significantly after adjustment of medical therapy.
Conclusions: Mid-term prognosis of selected patients considered `too well' for transplantion is comparable to patients immediately listed. Lower left ventricular filling pressures, smaller hearts on chest X-ray on initial evaluation, and improvement of symptoms during follow up may identify a subgroup of patients who do well on optimized therapy.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>9579819</pmid><doi>10.1016/S0167-5273(98)00007-2</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Actuarial Analysis Adult Biological and medical sciences Cardiology. Vascular system Cause of Death Confidence Intervals Congestive heart failure Disease Progression Echocardiography Female Follow-Up Studies Heart Heart Failure - diagnosis Heart Failure - mortality Heart Failure - therapy Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart transplantation Heart Transplantation - statistics & numerical data Hemodynamics Humans Male Medical sciences Medical therapy Middle Aged Patient Selection Predictive Value of Tests Prognosis Retrospective Studies Severity of Illness Index Survival Rate |
| title | Prognosis of medically treated patients referred for cardiac transplantation |
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