Background: Heart transplant (HT) recipients tend to develop unfavorable ventricular-arterial interactions, yet the prognostic implications of this altered physiology remain unclear. We aimed to identify the presence of afterload mismatch (AM) after heart transplantation, its determinants, and its impact on long-term cardiac mortality. Methods: An observational, single-center study was conducted on the historical cohort of patients who received HT at our institution. Patients survived the first year after HT with a LVEF ≥50%, cardiac allograft vasculopathy grades 0 to 1, and acute cellular rejection grades 0 to 1R. Arterial elastance and ventricular elastance were calculated noninvasively using blood pressure, end-systolic volume, and end-diastolic volume. Patients were grouped as follows: low afterload (LA- arterial elastance
Afterload Mismatch Is Associated With Higher Cardiac Mortality After Heart Transplantation
Corianò, Mattia;Pradegan, Nicola;Tarzia, Vincenzo;Angelini, Annalisa;Tessari, Chiara;Gerosa, Gino;Tona, Francesco
2025
Abstract
Background: Heart transplant (HT) recipients tend to develop unfavorable ventricular-arterial interactions, yet the prognostic implications of this altered physiology remain unclear. We aimed to identify the presence of afterload mismatch (AM) after heart transplantation, its determinants, and its impact on long-term cardiac mortality. Methods: An observational, single-center study was conducted on the historical cohort of patients who received HT at our institution. Patients survived the first year after HT with a LVEF ≥50%, cardiac allograft vasculopathy grades 0 to 1, and acute cellular rejection grades 0 to 1R. Arterial elastance and ventricular elastance were calculated noninvasively using blood pressure, end-systolic volume, and end-diastolic volume. Patients were grouped as follows: low afterload (LA- arterial elastance
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