Scientific publications
Prognosis after heart transplant in patients with hypertrophic and restrictive cardiomyopathy
Francisco González-Urbistondo 1 , Luis Almenar-Bonet 2 , Manuel Gómez-Bueno 3 , Marisa Crespo-Leiro 4 , Francisco González-Vílchez 5 , María Dolores García-Cosío 6 , Amador López-Granados 7 , Sonia Mirabet 8 , Manuel Martínez-Sellés 9 , José Manuel Sobrino 10 , Carles Díez-López 11 , Marta Farrero 12 , Beatriz Díaz-Molina 13 , Gregorio Rábago 14 , Luis de la Fuente-Galán 15 , Iris Garrido-Bravo 16 , María Teresa Blasco-Peiró 17 , Antonio García-Quintana 18 , José Antonio Vázquez de Prada 5
Introduction and objectives: Posttransplant outcomes among recipients with a diagnosis of hypertrophic cardiomyopathy (HCM) or restrictive cardiomyopathy (RCM) remain controversial.
Methods: Retrospective analysis of a nationwide registry of first-time recipients undergoing isolated heart transplant between 1984 and 2021. One-year and 5-year mortality in recipients with HCM and RCM were compared with those with dilated cardiomyopathy (DCM).
Results: We included 3703 patients (3112 DCM; 331 HCM; 260 RCM) with a median follow-up of 5.0 [3.1-5.0] years. Compared with DCM, the adjusted 1-year mortality risk was: HCM: HR, 1.38; 95%CI, 1.07-1.78; P=.01, RCM: HR, 1.48; 95%CI, 1.14-1.93; P=.003. The adjusted 5-year mortality risk was: HCM: HR, 1.17; 95%CI, 0.93-1.47; P=.18; RCM: HR, 1.52; 95%CI, 1.22-1.89; P<.001. Over the last 20 years, the RCM group showed significant improvement in 1-year survival (adjusted R2=0.95) and 5-year survival (R2=0.88); the HCM group showed enhanced the 5-year survival (R2=0.59), but the 1-year survival remained stable (R2=0.16).
Conclusions: Both RCM and HCM were linked to a less favorable early posttransplant prognosis compared with DCM. However, at the 5-year mark, this unfavorable difference was evident only for RCM. Notably, a substantial temporal enhancement in both early and late mortality was observed for RCM, while for HCM, this improvement was mainly evident in late mortality.
CITATION Rev Esp Cardiol (Engl Ed). 2023 Nov 19:S1885-5857(23)00308-0. doi: 10.1016/j.rec.2023.10.006
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