Cargando…

Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades

Data on post–heart transplant (HT) survival of patients with Chagas cardiomyopathy (CC) are scarce. We sought to evaluate post-HT survival in patients with CC as compared with other causes of heart failure across different eras of HT. METHODS. We conducted a retrospective, cohort study of 376 adult...

Descripción completa

Detalles Bibliográficos
Autores principales: Vieira, Jefferson L., Sobral, Maria G. V., Macedo, Francisco Y., Florêncio, Raquel S., Almeida, Germana P. L., Vasconcelos, Glauber G., Fernandes, Juliana R., Marinho, Laura L. E., Trompieri, Daniel F. M., Pasala, Tilak K. R., Mejia, Juan A. C., Souza-Neto, João D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236606/
https://www.ncbi.nlm.nih.gov/pubmed/35774419
http://dx.doi.org/10.1097/TXD.0000000000001349
_version_ 1784736568854970368
author Vieira, Jefferson L.
Sobral, Maria G. V.
Macedo, Francisco Y.
Florêncio, Raquel S.
Almeida, Germana P. L.
Vasconcelos, Glauber G.
Fernandes, Juliana R.
Marinho, Laura L. E.
Trompieri, Daniel F. M.
Pasala, Tilak K. R.
Mejia, Juan A. C.
Souza-Neto, João D.
author_facet Vieira, Jefferson L.
Sobral, Maria G. V.
Macedo, Francisco Y.
Florêncio, Raquel S.
Almeida, Germana P. L.
Vasconcelos, Glauber G.
Fernandes, Juliana R.
Marinho, Laura L. E.
Trompieri, Daniel F. M.
Pasala, Tilak K. R.
Mejia, Juan A. C.
Souza-Neto, João D.
author_sort Vieira, Jefferson L.
collection PubMed
description Data on post–heart transplant (HT) survival of patients with Chagas cardiomyopathy (CC) are scarce. We sought to evaluate post-HT survival in patients with CC as compared with other causes of heart failure across different eras of HT. METHODS. We conducted a retrospective, cohort study of 376 adult HT recipients between October 1997 and November 2019. Participants were classified according to the etiology of heart failure as CC (N = 66), nonischemic cardiomyopathy (N = 214), and ischemic cardiomyopathy (N = 96), and according to the era of HT as early (1997–2009), recent (2010–2014), and current era (2015–2019). RESULTS. After a mean follow-up of 5.0 y (0–20.5 y), post-HT survival rates at 1, 5, and 10 y were comparable between groups. One-y survival improved from 70% in the early eras to 80% in the current era (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.41-0.97; P = 0.034). After adjustment for sex, age, and mechanical circulatory support, time-related improvement in survival was observed only in patients without CC (HR, 0.54; 95% CI, 0.32-0.91; P = 0.019) but not in those with CC (HR, 0.99; 95% CI, 0.36-2.73; P = 0.98). Causes of death were similar between patients with CC and the other etiological subgroups. CONCLUSIONS. Posttransplant survival is comparable between patients with CC, nonischemic cardiomyopathy, and ischemic cardiomyopathy. Although survival has improved significantly over years for most HT recipients, it has remained unchanged for those with Chagas disease. These trends underscore the importance of scientific research, policy discussions and a collaborative registry of heart transplantation in Chagas cardiomyopathy.
format Online
Article
Text
id pubmed-9236606
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-92366062022-06-29 Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades Vieira, Jefferson L. Sobral, Maria G. V. Macedo, Francisco Y. Florêncio, Raquel S. Almeida, Germana P. L. Vasconcelos, Glauber G. Fernandes, Juliana R. Marinho, Laura L. E. Trompieri, Daniel F. M. Pasala, Tilak K. R. Mejia, Juan A. C. Souza-Neto, João D. Transplant Direct Heart Transplantation Data on post–heart transplant (HT) survival of patients with Chagas cardiomyopathy (CC) are scarce. We sought to evaluate post-HT survival in patients with CC as compared with other causes of heart failure across different eras of HT. METHODS. We conducted a retrospective, cohort study of 376 adult HT recipients between October 1997 and November 2019. Participants were classified according to the etiology of heart failure as CC (N = 66), nonischemic cardiomyopathy (N = 214), and ischemic cardiomyopathy (N = 96), and according to the era of HT as early (1997–2009), recent (2010–2014), and current era (2015–2019). RESULTS. After a mean follow-up of 5.0 y (0–20.5 y), post-HT survival rates at 1, 5, and 10 y were comparable between groups. One-y survival improved from 70% in the early eras to 80% in the current era (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.41-0.97; P = 0.034). After adjustment for sex, age, and mechanical circulatory support, time-related improvement in survival was observed only in patients without CC (HR, 0.54; 95% CI, 0.32-0.91; P = 0.019) but not in those with CC (HR, 0.99; 95% CI, 0.36-2.73; P = 0.98). Causes of death were similar between patients with CC and the other etiological subgroups. CONCLUSIONS. Posttransplant survival is comparable between patients with CC, nonischemic cardiomyopathy, and ischemic cardiomyopathy. Although survival has improved significantly over years for most HT recipients, it has remained unchanged for those with Chagas disease. These trends underscore the importance of scientific research, policy discussions and a collaborative registry of heart transplantation in Chagas cardiomyopathy. Lippincott Williams & Wilkins 2022-06-24 /pmc/articles/PMC9236606/ /pubmed/35774419 http://dx.doi.org/10.1097/TXD.0000000000001349 Text en Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Heart Transplantation
Vieira, Jefferson L.
Sobral, Maria G. V.
Macedo, Francisco Y.
Florêncio, Raquel S.
Almeida, Germana P. L.
Vasconcelos, Glauber G.
Fernandes, Juliana R.
Marinho, Laura L. E.
Trompieri, Daniel F. M.
Pasala, Tilak K. R.
Mejia, Juan A. C.
Souza-Neto, João D.
Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades
title Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades
title_full Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades
title_fullStr Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades
title_full_unstemmed Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades
title_short Long-term Survival Following Heart Transplantation for Chagas Versus Non-Chagas Cardiomyopathy: A Single-center Experience in Northeastern Brazil Over 2 Decades
title_sort long-term survival following heart transplantation for chagas versus non-chagas cardiomyopathy: a single-center experience in northeastern brazil over 2 decades
topic Heart Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9236606/
https://www.ncbi.nlm.nih.gov/pubmed/35774419
http://dx.doi.org/10.1097/TXD.0000000000001349
work_keys_str_mv AT vieirajeffersonl longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT sobralmariagv longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT macedofranciscoy longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT florencioraquels longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT almeidagermanapl longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT vasconcelosglauberg longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT fernandesjulianar longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT marinholaurale longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT trompieridanielfm longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT pasalatilakkr longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT mejiajuanac longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades
AT souzanetojoaod longtermsurvivalfollowinghearttransplantationforchagasversusnonchagascardiomyopathyasinglecenterexperienceinnortheasternbrazilover2decades