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Updated: Jul 18, 2025
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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
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Predicted Heart Mass: A Tale of 2 Ventricles
Eduard Ródenas-Alesina1, Farid Foroutan2, Chun-Po Fan2
1Ted Rogers Centre for Heart Research (E.R.-A., I.B., N.A., H.J.R., Y.M.), Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
Circulation. Heart Failure
|August 21, 2023
Summary
Assessing donor and recipient predicted heart mass (PHM) separately for the left and right ventricles improves 1-year graft failure risk prediction after heart transplantation. This refined matching strategy enhances donor-recipient compatibility and donor organ utilization.
Area of Science:
- Cardiology
- Transplantation Medicine
- Biostatistics
Background:
- Total predicted heart mass (PHM) is standard for donor-recipient size matching in heart transplantation.
- Separate measurement of right ventricular (RV) and left ventricular (LV) PHM may enhance risk prediction for 1-year graft failure.
Purpose of the Study:
- To evaluate if separate LV and RV PHM assessment improves risk prediction of 1-year graft failure compared to total PHM.
- To assess the reclassification of risk using combined LV and RV PHM versus total PHM.
Main Methods:
- Analysis of adult heart transplant recipients from the UNOS database (2000-2018).
- Modeling of LV and RV PHM using restricted cubic splines.
- Adjusted Cox regression to determine association with 1-year graft failure.
- Net reclassification index (NRI) to assess risk reclassification.
Main Results:
- A U-shaped association was observed between total PHM and 1-year graft failure risk.
- Increased graft failure risk was noted for LV undersizing (>5%) and RV oversizing (>20%).
- Separate LV/RV PHM assessment yielded an NRI of 8.5% for improved risk reclassification.
Conclusions:
- Donor-recipient PHM matching risk is influenced by LV undersizing and RV oversizing.
- Separate assessment of LV and RV PHM refines donor-recipient matching for heart transplantation.
- This approach may minimize 1-year graft failure and increase donor organ utilization.
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