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Prolonged corrected QT interval in the donor heart: Is there a risk?

Derek Leong1, Tamar Aintablian1, Michelle Kittleson1

  • 1Cedars-Sinai Heart Institute, Los Angeles, CA, USA.

Clinical Transplantation
|May 5, 2017
PubMed

Insights

Donor hearts with a corrected QT (QTc) interval over 500 milliseconds are linked to increased early cardiac allograft vasculopathy (CAV) after heart transplantation.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Cardiac Electrophysiology

Background:

  • Assessing donor QT interval is crucial for excluding long QT syndrome.
  • A corrected QT (QTc) interval >500 milliseconds in donor hearts raises concerns.

Purpose of the Study:

  • To evaluate first-year post-transplant outcomes for recipients receiving hearts from donors with a QTc interval >500 milliseconds.

Main Methods:

  • A cohort of 257 donor hearts with QTc >500 milliseconds were assessed between 2010-2014.
  • Outcomes included 1-year survival, freedom from rejection, freedom from cardiac allograft vasculopathy (CAV), and freedom from major adverse cardiac events.

Main Results:

  • Patients receiving hearts from donors with QTc >500 milliseconds had significantly lower 1-year freedom from CAV.
  • Donor QTc >500 milliseconds was associated with a 6.7-fold increased risk of developing CAV (P=.029).
  • Donors with QTc >500 milliseconds had a higher incidence of stroke or subarachnoid hemorrhage.

Conclusions:

  • Donor QTc >500 milliseconds is an independent risk factor for early CAV post-heart transplantation.
  • This association may be due to increased immunological risk.
Abstract

Keywords:
QT intervalcardiac allograft vasculopathyheart transplantation

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