Determinants of left ventricular function one year after cardiac transplantation

Left ventricular systolic function was assessed by radionuclide angiography in 107 consecutive transplant recipients who were alive one year after operation. Mean (SEM) ejection fraction was 62.4 (4.6) at rest and 68.8 (5.4) on exercise. The influence of donor-related factors (donor age and sex, ischaemia time), recipient-related factors (recipient age and sex, frequency of acute rejection), type of immunosuppression (cyclosporin/azathioprine or prednisolone/azathioprine), and frequency of hypertension on left ventricular function one year after operation was examined by univariate and multivariate analysis. There was a close association both at rest and on exercise between a higher ejection fraction and treatment with cyclosporin/azathioprine. There was a trend for lower donor and recipient age, shorter ischaemia time, and fewer rejection episodes to be associated with better left ventricular function, but this was not statistically significant. Left ventricular systolic function was well maintained in most patients a year after cardiac transplantation. The type of immunosuppression used had a strong influence on the left ventricular systolic function of the transplanted heart.