Does heart transplantation confer additional benefit over medical therapy to patients who have waited >6 months for heart transplantation?
Journal of the American College of CardiologyPublished 1 November 1994
Walter Kao, Dan McGee, Youlian Liao, Alain Heroux, G. M. Mullen, Maryl R. Johnson
Citations19
SJR quartileQ1
SJR score9.02
SNIP6.30
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
It is concluded that heart transplantation should still be considered a therapeutic alternative in patients with heart failure even after a prolonged waiting period on the heart transplant waiting list.
Abstract
Survival of patients who have survived > 6 months on the heart transplant waiting list is generally good. Although heart transplantation did not appear to confer additional survival advantage over medical therapy, a large proportion of the patients who underwent transplantation were critically ill at the time of transplantation and would undoubtedly have died of progressive heart failure had they not undergone transplantation. We conclude that heart transplantation should still be considered a therapeutic alternative in patients with heart failure even after a prolonged waiting period on the heart transplant waiting list.
Keywords
MedicineEngineering
New England Journal of MedicineEffect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure
8,006 Citations1991The SOLVD Investigators*
The addition of enalapril to conventional therapy significantly reduced mortality and hospitalizations for heart failure in patients with chronic congestive heart failure and reduced ejection fractions.
New England Journal of MedicineEffects of Enalapril on Mortality in Severe Congestive Heart Failure
5,077 Citations1987The Consensus Trial Study Group*
It is concluded that the addition of enalapril to conventional therapy in patients with severe congestive heart failure can reduce mortality and improve symptoms and a significant improvement in NYHA classification was observed in the enAlapril group.
The American Journal of CardiologyEffects of enalapril on mortality in severe congestive heart failure: Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS)
3,778 Citations1988Karl Swedberg, John Kjekshus
The addition of enalapril to conventional therapy in patients with severe congestive heart failure can reduce mortality and improve symptoms, and the effect seems to be due to a reduction in death from progression of heart failure.
New England Journal of MedicineThe Natural History of Congestive Heart Failure: The Framingham Study
3,478 Citations1971Patrick A. McKee, William P. Castelli +2 more
The natural history of congestive heart failure was studied over a 16-year period in 5192 persons initially free of the disease, finding that in almost every five-year age group, from 30 to 62 years, the incidence rate was greater for men than for women.
New England Journal of MedicinePlasma Norepinephrine as a Guide to Prognosis in Patients with Chronic Congestive Heart Failure
3,116 Citations1984Jay N. Cohn, T. Barry Levine +6 more
Measurements of Hemodynamics, plasma norepinephrine, and plasma renin activity in patients with moderate to severe congestive heart failure suggest that a single resting venous blood sample showing the plasma norenphrine concentration provides a better guide to prognosis than other commonly measured indexes of cardiac performance.
New England Journal of MedicineA Comparison of Enalapril with Hydralazine–Isosorbide Dinitrate in the Treatment of Chronic Congestive Heart Failure
2,836 Citations1991Jay N. Cohn, Gary R. Johnson +17 more
The different effects of the two regimens (enalapril and hydralazine-isosorbide dinitrate) on mortality and physiologic end points suggest that the profile of effects might be enhanced if the regimens were used in combination.
New England Journal of MedicineEffect of Oral Milrinone on Mortality in Severe Chronic Heart Failure
2,212 Citations1991Milton Packer, Joseph R. Carver +13 more
The findings indicate that despite its beneficial hemodynamic actions, long-term therapy with oral milrinone increases the morbidity and mortality of patients with severe chronic heart failure.
The LancetBeneficial effects of metoprolol in idiopathic dilated cardiomyopathy
1,234 Citations1993Finn Waagstein, Åke Hjalmarson +8 more
In patients with idiopathic dilated cardiomyopathy, treatment with metoprolol prevented clinical deterioration, improved symptoms and cardiac function, and was well tolerated.
JAMAThe Limited Reliability of Physical Signs for Estimating Hemodynamics in Chronic Heart Failure
973 Citations1989Lynne Warner Stevenson
The cardiovascular physical examination is used commonly as a basis for diagnosis and therapy in chronic heart failure, although the relationship between physical signs, increased ventricular filling pressure, and decreased cardiac output has not been established for this population.
The American Journal of CardiologyCorrelates and prognostic implication of exercise capacity in chronic congestive heart failure
498 Citations1985Jadwiga Szlachcic, Barry M. Masse +3 more
Patients with severely impaired exercise tolerance had significantly higher rest pulmonary capillary wedge and right atrial pressures than those with a VO2max of 10 to 18 ml/min/kg; however, overlap among individual patients was considerable, and only pulmonaryCapillary wedge pressure at rest correlated significantly withVO2max.
The American Journal of CardiologyClinical determinants of mortality in chronic congestive heart failure secondary to idiopathic dilated or to ischemic cardiomyopathy
459 Citations1987Mariell J. Likoff, Sheryl L. Chandler +1 more
Patients at high risk with left ventricular dysfunction associated with ischemic heart disease, a decreasing exercise tolerance and the development of an S3 should be strongly considered for an interventional trial with the aim of decreasing mortality.
Journal of the American College of CardiologyPrognosis in severe heart failure: Relation to hemodynamic measurements and ventricular ectopic activity
395 Citations1983John Wilson, J. Sanford Schwartz +5 more
It is concluded that severe heart failure is associated with a high mortality from both sudden and nonsudden cardiac death and cardiac mortality is independently related to functional status but not to the level of pump dysfunction, cardiac size or ventricular ectopic activity.
JAMACurrent Status of Cardiac Transplantation
115 Citations1998Sharon A. Hunt
Cardiac transplantation, first introduced 30 years ago, has become a widely used and increasingly important procedure for treatment of truly end-stage heart disease, but current use is limited strictly by donor supply, making selection of appropriate recipients an important ethical and societal issue.
New England Journal of MedicineThe Prevention of Heart Failure — A New Agenda
95 Citations1992Jay N. Cohn
A new drug called enalapril plus hydralazine plus isosorbide dinitrate dinitration is introduced into the treatment of chronic congestive heart failure to improve survival and improve quality of life in patients with this disease.
Journal of the American College of CardiologyDecreasing survival benefit from cardiac transplantation for outpatients as the waiting list lengthens
93 Citations1991Lynne W. Stevenson, Michèle A. Hamilton +6 more
The expected improvement in survival after transplantation would be only 5% over the subsequent year for patients waiting 6 months, which is the waiting time for many outpatients, according to the impact of the current waiting times and priority system.
PubMedOutpatient dobutamine for refractory congestive heart failure: advantages, techniques, and results.
39 Citations1991L.W. Miller
Patients with refractory, end-stage congestive heart failure awaiting heart transplantation may be treated efficaciously with intermittent infusions of dobutamine given on an outpatient basis using a tunneled subcutaneous catheter, which essentially eliminates the risk of infection associated with this type of delivery system.