Long-term follow-up of heart transplant patients

The present study was designated to assess long term functional capacity, blood pressure and renal function at 12 and 60 months after heart transplantation. The data of sixty heart transplant recipients were retrospectively reviewed. At rest, radionuclide ejection fraction and cardiac index measured by thermodilution were within normal range, demonstrating normal left systolic function. In all patients, exercise tests were performed sitting on a bicycle. Peak oxygen uptake decreased from 23 +/- 6 to 19 +/- 6 ml/kg/min (mean +/- S.D.) respectively at 12 and 60 months after surgery (p < 0.01), which represent a 17% diminution in functional capacity. This decrease is nevertheless only related with a 10 kg increase in total body weight (69 +/- 9; 79 +/- 12 kg; p < 0.001) and thus absolute peak oxygen uptake remained unchanged. Blood pressure rised significantly since the first month after transplantation. Sixty-seven percent of recipients had systemic hypertension at 60 months, despite medical therapy. A decline in renal function was observed in all patients, beginning after the first year of transplantation.