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Heart transplantation provides long-term survival benefit in stable patients experiencing heart failure without

Brigitte Meyer1, Deddo Moertl, Martin Huelsmann

  • 1Department of Cardiology, Medical University of Vienna, Vienna, Austria.

Transplantation
|December 14, 2006
PubMed

Insights

Heart transplantation offers long-term survival benefits for stable chronic heart failure patients. However, those with improved left ventricular ejection fraction (LVEF) after medical therapy may not see the same advantage.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Heart Failure Management

Background:

  • Optimized medical therapy for chronic heart failure (CHF) does not offer short-term survival benefits in stable patients.
  • Long-term outcomes of stable CHF patients versus heart transplant recipients require comparison.

Purpose of the Study:

  • To compare the long-term survival of stable chronic heart failure patients with those who have undergone heart transplantation.
  • To identify predictors of long-term survival in this patient population.

Main Methods:

  • Evaluated 318 potential heart transplant candidates (NYHA class III/IV, LVEF <35%) between 1995-1997.
  • Optimized medical therapy for 108 stable outpatients; 70 patients underwent transplantation.
  • Followed patients for 7-10 years to assess survival outcomes.

Main Results:

  • Heart transplantation significantly improved long-term survival compared to optimized medical therapy (HR 0.90, P=0.01).
  • One-year left ventricular ejection fraction (LVEF) > or = 30% was the best predictor of survival.
  • Patients with LVEF <30% had significantly lower survival than transplanted patients (HR 0.82, P<0.001).

Conclusions:

  • Heart transplantation provides long-term survival benefits for stable CHF patients (7-10 years).
  • Patients achieving LVEF > or = 30% with medical optimization may not benefit from transplantation.
  • LVEF is a critical factor in determining long-term prognosis for CHF patients.
Abstract

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