Rajagopalan N, Dennis DR, Akhtarekhavari J, Campbell K. Abnormal invasive hemodynamics in heart transplant recipients: A single-center, retrospective study. World J Transplant 2025; 15(3): 101245 [DOI: 10.5500/wjt.v15.i3.101245]
Corresponding Author of This Article
Navin Rajagopalan, MD, Professor, Department of Internal Medicine, University of Kentucky, 900 South Limestone Street, Lexington, KY 40536, United States. navin_rajagopalan@yahoo.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 18, 2025; 15(3): 101245 Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.101245
Abnormal invasive hemodynamics in heart transplant recipients: A single-center, retrospective study
Navin Rajagopalan, Donna R Dennis, Julia Akhtarekhavari, Kenneth Campbell
Navin Rajagopalan, Donna R Dennis, Julia Akhtarekhavari, Department of Internal Medicine, University of Kentucky, Lexington, KY 40536, United States
Kenneth Campbell, Department of Physiology, Center for Muscle Biology, University of Kentucky, Lexington, KY 40536, United States
Author contributions: Rajagopalan N was responsible for study design and data analysis and primary role in writing the manuscript; Dennis DR and Akhtarekhavari J were responsible for study design and assisted with data acquisition; Campbell K was responsible for study design and statistical analysis; all authors contributed to the writing and editing of the manuscript, read and approved the final version of the manuscript to be published.
Institutional review board statement: Our retrospective analysis has been approved by the University of Kentucky’s Institutional Review Board. The title of the protocol that encompasses our research is titled: “Cardiovascular Outcomes Research and Education”. The Institutional Review Board at our institution governs the proper ethical conduct of research and all researchers agree to accept responsibility for the scientific and ethical conduct of the study.
Informed consent statement: Participants were not required to provide informed consent for this retrospective study. Data was de-identified and collected retrospectively for this cohort study.
Conflict-of-interest statement: Navin Rajagopalan has served as a consultant for Abbott Laboratories. The other authors have no conflicts of interest to report.
Data sharing statement: De-identified data can be requested and considered by the authors on a case-by-case basis.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Navin Rajagopalan, MD, Professor, Department of Internal Medicine, University of Kentucky, 900 South Limestone Street, Lexington, KY 40536, United States. navin_rajagopalan@yahoo.com
Received: September 8, 2024 Revised: February 16, 2025 Accepted: February 21, 2025 Published online: September 18, 2025 Processing time: 221 Days and 14.7 Hours
Abstract
BACKGROUND
Few studies have quantified invasive hemodynamic parameters in post heart transplant recipients.
AIM
To report the incidence of abnormal hemodynamics in heart transplant recipients at 1-year and 3-year post-transplant and determine if there was any correlation with recipient and donor characteristics.
METHODS
Data from 279 consecutive heart transplant recipients from 2007 through 2020 were analyzed. Clinical variables regarding both recipients and donors as well as hemodynamic variables obtained via right heart catheterization during 1-year and 3-year annual testing were recorded. Simple and multiple linear regression tests were used to determine how recipient and donor variables influenced hemodynamic parameters at 1-year and 3-year.
RESULTS
Data were available for 260 patients and 224 patients at 1-year and 3-year post-transplant respectively. At 1-year, abnormal hemodynamic parameters were common with 24% patients having right atrial pressure (RAP) > 10 mmHg, 52% with mean pulmonary artery pressure > 20 mmHg, and 12% with pulmonary capillary wedge pressure (PCWP) > 18 mmHg. Similar abnormalities were noted at 3-year post-transplant. Recipient body mass index (BMI) demonstrated the strongest correlation with all 3 variables at both 1-year and 3-year by multivariate linear regression analysis (P < 0.001 for both). Both donor age and predicted heart mass difference between recipient and donor were significantly linked to RAP and PCWP at 1-year but did not predict any variables at 3-year post-transplant.
CONCLUSION
Abnormal hemodynamics are common at 1-year and 3-year post-transplant and are associated with recipients with high BMI.
Core Tip: Our research demonstrates that abnormal invasive hemodynamics are commonly observed in heart transplant recipients at 1-year and 3-year post-transplantation. Obesity as reflected by body mass index was strongly associated with elevated right atrial, mean pulmonary artery, and pulmonary capillary wedge pressure in transplant recipients. Further research is needed to determine if the development of abnormal hemodynamics predicts transplant mortality and if behavioral modifications and pharmacologic therapy can reverse observed hemodynamic abnormalities.
