Turk Kardiyol Dern Ars. 2005; 33(3): 149-154

Indicators of mortality in patients who are placed on the heart transplant waiting list because of end-stage heart failure

Hamza Duygu¹, Mehdi Zoghi¹, Sanem Nalbantgil¹, Tahir Yağdı², Mustafa Akın¹, Mustafa Özbaran², İsa Durmaz^2
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OBJECTIVES
This study was designed to compare clinical, electrocardiographic, echocardiographic, and hemodynamic features of patients with end-stage cardiac failure, who died or were alive while on the heart transplant waiting list.
STUDY DESIGN
Sixty patients (47 men, 11 women; mean age 56±11 years) who were on the waiting list were studied in two groups. Group I included those who died (n=26; 17 men, 9 women; mean age 44±17 years) and group II included those who were alive (n=34; 30 men, 4 women; mean age 46±5 years) while waiting for a suitable donor. The two groups were compared with regard to demographic and clinical (United Network for Organ Sharing - UNOS - status) characteristics, medical therapies, risk factors for coronary artery disease, electrocardiographic (QT dispersion, QRS duration) and echocardiographic findings, and hemodynamic parameters.
RESULTS
No significant differences existed between the two groups with regard to age, risk factors for atherosclerosis, atrial fibrillation, etiologies of heart failure, and the cardiac index. However, the following parameters differed significantly in group I: the number of female patients (p=0.04); the number of patients with IB status according to the UNOS criteria (p=0.01); both the QT dispersion interval and corrected QT dispersion (p<0.001); right ventricular ejection fraction (p=0.002); pulmonary artery systolic pressure (p=0.002) and right ventricular end-diastolic diameter (p=0.01); and transpulmonary gradient (p<0.03).
CONCLUSION
Consideration of significant determinants of mortality in patients awaiting heart transplantation may contribute to decreases in mortality due to heart failure.

Keywords: Death, sudden, cardiac; electrocardiography; heart failure, congestive/mortality/surgery; heart transplantation; prognosis; risk assessment; time factors; ventricular function, left; waiting lists

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