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• W3137029309 abstract "<h3>Purpose</h3> High right atrial pressure (RAP) is associated with deranged renal function and mortality in patients with heart failure. We hypothesised that : 1.This effect may persist after heart transplantation 2. It is essentially mediated through a low organ perfusion pressure indexed to body surface area (OPPI). 3.That OPPI is more sensitive than organ perfusion pressure (OPP) alone in predicting survival. <h3>Methods</h3> The data from 250 patients who had a heart transplant over a 8 period from October 2012 to march 2020 was analyzed for the effect of OPPI and OPP. OPP was calculated as :Mean arterial pressure (MAP) - RAP and OPPI as (MAP-RAP)/body surface area .OPPI value of 40 and OPP of 60 mm hg were chosen for analysis as they were close to the median values. <h3>Results</h3> There was a more significant negative correlation between OPPI and creatinine (r = -0.3551,p =0.000) than OPP and creatinine (r = -0.0688,p = 0.3414).The effect of OPPI on MELD score was more pronounced than OPP.( r = -0.3580, p = 0.000 vs r = -0.1504, p = 0.062). OPPI also had a more significant effect on 90 day mortality than OPP (odds ratio 0.89, p = 0.004 vs odds ratio 1.01 ,p = 0.677). The 90 day mortality for OPPI less than and more than 40 was 23.2 % vs 7.1 %, p = 0.001.This effect of OPPI and OPP on 90 day mortality was absent if RAP was less than 15 mm hg. The effect of OPPI on survival persisted at a follow up of beyond 5 years. (72 % vs 54 % , p = 0.0124).The effect was absent if the RAP was less than 15. The effect was more pronounced for OPPI than OPP. <h3>Conclusion</h3> 90 day and 5 year survival after heart transplantation are worse in patients with low organ perfusion pressure indexed to BSA . OPPI less than 40 appears to be deleterious . Vasodilator drugs used to treat systolic left heart failure may adversely affect survival if RAP is high, to be used with caution." @default.
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• W3137029309 date "2021-04-01" @default.
• W3137029309 modified "2023-09-26" @default.
• W3137029309 title "Low Organ Perfusion Pressure Indexed to Body Surface Area is a Powerful Predictor of Poor Outcomes Even after Heart Transplantation in the Presence of High Right Atrial Pressure" @default.
• W3137029309 doi "https://doi.org/10.1016/j.healun.2021.01.765" @default.
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