Does the Degree of Diastolic Dysfunction in the First Year After Heart Transplant Affect Subsequent Outcomes?

Diastolic dysfunction in the first year post-heart transplantation (HTx) is not uncommon. This can be due to hypertension, rejection, or calcineurin inhibitor therapy treatments. It has not been well established whether this first-year diastolic dysfunction affects outcome post-HTx. Between 2010 and 2016, we assessed HTx patients who developed diastolic dysfunction by echocardiography in the first year post-HTx. Patients with diastolic dysfunction were further divided into groups with mild, moderate, and severe diastolic dysfunction as determined by echo parameters. These patients were compared to patients who survived the first year who had no evidence of diastolic dysfunction. Subsequent 5-year survival, cardiac function (echocardiogram ejection fraction), cardiac allograft vasculopathy (CAV: stenosis ≥30% by angiography), and non-fatal major adverse cardiac events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke) were assessed for the patient groups. Patients with diastolic dysfunction had significantly lower 5-year survival and freedom from NF-MACE compared to the control group. The development of CAV at 5 years post-HTx was not significantly different among the study groups. There was not a linear correlation of worsening diastolic dysfunction to poorer outcomes. (See table.) Any diastolic dysfunction appears to be a risk factor for poor outcomes post-HTx and should be addressed in terms of comorbid problems. [ABSTRACT FROM AUTHOR]