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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...

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Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
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Published on: November 26, 2018

Right ventricular dysfunction predicts poor outcome following hemodynamically compromising rejection.

François Haddad1, Patrick Fisher, Michael Pham

  • 1Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California 94305-5406, USA. fhaddad@cvmed.stanford.edu

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|April 1, 2009
PubMed
Summary
This summary is machine-generated.

Right ventricular dysfunction is a significant predictor of poor outcomes in heart transplant patients experiencing hemodynamically compromising rejection (HCR). This finding highlights RV function as a key factor in survival post-transplant, even with modern immunosuppression.

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Last Updated: Jun 24, 2026

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08:49

Cardiac Loading using Passive Left Atrial Pressurization and Passive Afterload for Graft Assessment

Published on: August 2, 2024

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Immunology

Background:

  • Hemodynamically compromising rejection (HCR) is a critical complication following heart transplantation, significantly impacting patient mortality and morbidity.
  • Right ventricular (RV) function is a well-established prognostic indicator in conditions such as heart failure and myocarditis.

Purpose of the Study:

  • To investigate whether right ventricular (RV) dysfunction serves as a predictive factor for event-free survival in heart transplant recipients diagnosed with HCR.
  • To identify novel risk factors associated with adverse outcomes in the context of HCR after heart transplantation.

Main Methods:

  • A retrospective review of medical records from 548 heart transplant patients at Stanford University (January 1998 - January 2007).
  • HCR was defined as a rejection episode necessitating hospitalization for heart failure.
  • Univariate and multivariate analyses were employed to ascertain risk factors for 1-year death or retransplantation.

Main Results:

  • HCR occurred in 12.9% of patients (71/548); 39% (28/71) experienced death or retransplantation within 1 year.
  • Univariate analysis revealed non-cellular rejection, inotropic support, RV dysfunction, left ventricular ejection fraction, and acute renal failure as significant predictors.
  • Multivariate analysis confirmed RV dysfunction (OR=4.80, p=0.007) and the need for inotropic support (OR=5.00, p=0.009) as independent predictors of 1-year adverse outcomes.

Conclusions:

  • Despite advancements in immunosuppression, hemodynamically compromising rejection (HCR) remains a substantial post-heart transplant complication.
  • Right ventricular (RV) dysfunction has been identified as a novel and significant risk factor for mortality or retransplantation following HCR.