FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4224258082> ?p ?o ?g. }

• W4224258082 endingPage "S141" @default.
• W4224258082 startingPage "S140" @default.
• W4224258082 abstract "Purpose Elevated pulmonary vascular resistance (PVR) in left heart disease contributes to poor outcomes after pediatric heart transplant (HT). Medical management of high PVR pre-HT is controversial and insufficiently described. Methods We sought to characterize practice internationally by surveying physicians at pediatric HT centers via ISHLT and other networks. Results We received 49 complete responses from 39 centers in 16 countries. The majority of respondents were pediatric cardiologists (90%) practicing at centers offering pediatric heart (86%) and lung (55%) transplant. In patients with left heart failure and elevated baseline PVR, most centers (88%) perform acute vasoreactivity testing (AVT) during catheterization. Only half (51%) have established a maximum PVR for transplant eligibility, with most citing 6 WU*m2 or lower (80%) [range 4-8 WU], obtained after AVT (84%). The highest post-AVT PVR ever listed ranged from 4-14.4, median 6 WU*m2 (Figure). Pre-HT, phosphodiesterase 5 inhibitors are most frequently used to treat high PVR (65%); however, 31% never use pulmonary vasodilators. Implantation of a left ventricular assist device (LVAD) increases likelihood of medical therapy for PVR, though timing of initiation (pre- vs post-HT) and duration of therapy varies. Case scenarios demonstrate HT listing with post-transplant pulmonary vasodilator therapy is the favored approach for restrictive cardiomyopathy and elevated PVR, whereas LVAD +/- pulmonary vasodilators is favored for patients with dilated cardiomyopathy or postop LV dysfunction and high PVR, regardless of vasoreactivity. Most continue vasodilator therapy until PVR normalizes or short term (<6 months) post-transplant. Conclusion Practice regarding medical management of elevated PVR in children awaiting HT is heterogenous, with variable use of pulmonary vasodilators and a wide range of acceptable PVR cutoffs. Evidence-based guidelines are needed to ensure standardized care and equitable organ allocation. Elevated pulmonary vascular resistance (PVR) in left heart disease contributes to poor outcomes after pediatric heart transplant (HT). Medical management of high PVR pre-HT is controversial and insufficiently described. We sought to characterize practice internationally by surveying physicians at pediatric HT centers via ISHLT and other networks. We received 49 complete responses from 39 centers in 16 countries. The majority of respondents were pediatric cardiologists (90%) practicing at centers offering pediatric heart (86%) and lung (55%) transplant. In patients with left heart failure and elevated baseline PVR, most centers (88%) perform acute vasoreactivity testing (AVT) during catheterization. Only half (51%) have established a maximum PVR for transplant eligibility, with most citing 6 WU*m2 or lower (80%) [range 4-8 WU], obtained after AVT (84%). The highest post-AVT PVR ever listed ranged from 4-14.4, median 6 WU*m2 (Figure). Pre-HT, phosphodiesterase 5 inhibitors are most frequently used to treat high PVR (65%); however, 31% never use pulmonary vasodilators. Implantation of a left ventricular assist device (LVAD) increases likelihood of medical therapy for PVR, though timing of initiation (pre- vs post-HT) and duration of therapy varies. Case scenarios demonstrate HT listing with post-transplant pulmonary vasodilator therapy is the favored approach for restrictive cardiomyopathy and elevated PVR, whereas LVAD +/- pulmonary vasodilators is favored for patients with dilated cardiomyopathy or postop LV dysfunction and high PVR, regardless of vasoreactivity. Most continue vasodilator therapy until PVR normalizes or short term (<6 months) post-transplant. Practice regarding medical management of elevated PVR in children awaiting HT is heterogenous, with variable use of pulmonary vasodilators and a wide range of acceptable PVR cutoffs. Evidence-based guidelines are needed to ensure standardized care and equitable organ allocation." @default.
• W4224258082 created "2022-04-26" @default.
• W4224258082 creator A5012749818 @default.
• W4224258082 creator A5019555799 @default.
• W4224258082 creator A5033524588 @default.
• W4224258082 creator A5057834156 @default.
• W4224258082 creator A5061150083 @default.
• W4224258082 creator A5079723914 @default.
• W4224258082 creator A5091672842 @default.
• W4224258082 date "2022-04-01" @default.
• W4224258082 modified "2023-09-27" @default.
• W4224258082 title "International Practice Heterogeneity in Pediatric Left Heart Disease Related Pulmonary Hypertension" @default.
• W4224258082 doi "https://doi.org/10.1016/j.healun.2022.01.329" @default.
• W4224258082 hasPublicationYear "2022" @default.
• W4224258082 type Work @default.
• W4224258082 citedByCount "0" @default.
• W4224258082 crossrefType "journal-article" @default.
• W4224258082 hasAuthorship W4224258082A5012749818 @default.
• W4224258082 hasAuthorship W4224258082A5019555799 @default.
• W4224258082 hasAuthorship W4224258082A5033524588 @default.
• W4224258082 hasAuthorship W4224258082A5057834156 @default.
• W4224258082 hasAuthorship W4224258082A5061150083 @default.
• W4224258082 hasAuthorship W4224258082A5079723914 @default.
• W4224258082 hasAuthorship W4224258082A5091672842 @default.
• W4224258082 hasConcept C120770815 @default.
• W4224258082 hasConcept C126322002 @default.
• W4224258082 hasConcept C164705383 @default.
• W4224258082 hasConcept C178853913 @default.
• W4224258082 hasConcept C2776383484 @default.
• W4224258082 hasConcept C2778198053 @default.
• W4224258082 hasConcept C2778774980 @default.
• W4224258082 hasConcept C2778797674 @default.
• W4224258082 hasConcept C2778849806 @default.
• W4224258082 hasConcept C2780930700 @default.
• W4224258082 hasConcept C58245268 @default.
• W4224258082 hasConcept C71924100 @default.
• W4224258082 hasConceptScore W4224258082C120770815 @default.
• W4224258082 hasConceptScore W4224258082C126322002 @default.
• W4224258082 hasConceptScore W4224258082C164705383 @default.
• W4224258082 hasConceptScore W4224258082C178853913 @default.
• W4224258082 hasConceptScore W4224258082C2776383484 @default.
• W4224258082 hasConceptScore W4224258082C2778198053 @default.
• W4224258082 hasConceptScore W4224258082C2778774980 @default.
• W4224258082 hasConceptScore W4224258082C2778797674 @default.
• W4224258082 hasConceptScore W4224258082C2778849806 @default.
• W4224258082 hasConceptScore W4224258082C2780930700 @default.
• W4224258082 hasConceptScore W4224258082C58245268 @default.
• W4224258082 hasConceptScore W4224258082C71924100 @default.
• W4224258082 hasIssue "4" @default.
• W4224258082 hasLocation W42242580821 @default.
• W4224258082 hasOpenAccess W4224258082 @default.
• W4224258082 hasPrimaryLocation W42242580821 @default.
• W4224258082 hasRelatedWork W1083230281 @default.
• W4224258082 hasRelatedWork W17020087 @default.
• W4224258082 hasRelatedWork W1967983407 @default.
• W4224258082 hasRelatedWork W2024874310 @default.
• W4224258082 hasRelatedWork W2025535832 @default.
• W4224258082 hasRelatedWork W2138843917 @default.
• W4224258082 hasRelatedWork W2412475215 @default.
• W4224258082 hasRelatedWork W2810215787 @default.
• W4224258082 hasRelatedWork W4280489779 @default.
• W4224258082 hasRelatedWork W4294091517 @default.
• W4224258082 hasVolume "41" @default.
• W4224258082 isParatext "false" @default.
• W4224258082 isRetracted "false" @default.
• W4224258082 workType "article" @default.