Related Experiment Video

Updated: Jun 19, 2026

Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion
08:15

Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion

Published on: November 28, 2025

Risk stratification of patients with severe heart failure awaiting heart transplantation-prospective national

T Zieliński1, A Browarek, M Zembala

  • 1Department of Heart Failure and Transplantation, Institute of Cardiology-04-628 Warszawa, ul. Alpejska 42, Warsaw, Poland. tzielin@ikard.pd

Transplantation Proceedings
|October 28, 2009
PubMed

Insights

New biomarkers, NTproBNP and hsCRP, alongside the HFSS score, improve risk assessment for heart transplant candidates. Combining these factors enhances prediction of death or urgent transplantation in heart failure patients.

Area of Science:

  • Cardiology and Transplant Medicine
  • Biomarker Discovery and Validation
  • Risk Stratification in Heart Failure

Background:

  • Current risk assessment methods for heart transplant candidates often lack novel biomarkers.
  • Accurate prediction of outcomes is crucial for managing patients with advanced heart failure awaiting transplantation.

Purpose of the Study:

  • To evaluate the predictive value of NTproBNP and hsCRP, individually and combined with the Heart Failure Survival Score (HFSS), for heart transplant candidates.
  • To assess the utility of these biomarkers in identifying patients at high risk of mortality or urgent transplantation.

Main Methods:

  • A prospective registry collected data from 658 patients listed for heart transplantation.
  • The composite endpoint of death or urgent transplantation was monitored during follow-up.
  • Statistical analyses included Kaplan-Meier curves, multivariate Cox proportional hazard models, and ROC analyses.

Main Results:

  • The composite endpoint occurred in 24% of patients (15% death, 9% urgent transplantation).
  • NTproBNP and hsCRP levels, stratified by quartiles, significantly predicted risk (P < .000001 and P < .002, respectively).
  • Multivariate analysis confirmed NTproBNP (P < .01) and HFSS (P < .02) as significant predictors, with borderline significance for hsCRP (P = .057).
  • Combining HFSS, NTproBNP, and hsCRP improved the area under the curve (AUC) to 0.6943, suggesting enhanced predictive power.

Conclusions:

  • HFSS, NTproBNP, and hsCRP are independent predictors of survival and the need for urgent heart transplantation.
  • The combined analysis of these factors moderately increases their predictive value for risk stratification in heart transplant candidates.
Abstract

More Related Videos

Cardiac Loading using Passive Left Atrial Pressurization and Passive Afterload for Graft Assessment08:49

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

Published on: August 2, 2024

Related Concept Videos

Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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...