P705High donor age impairs diastolic function in heart transplant recipients


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Abstract

Purpose: Heart transplantation (HTx) improves survival in patients with congestive heart failure. In the need for suitable grafts, older donors are accepted. In healthy individuals, diastolic function impairs with increasing age. The impact of donor age on recipients' cardiac function has not been investigated with newer echocardiographic techniques. Thus, we studied whether donor age influence post-transplant systolic and diastolic function by tissue Doppler Imaging echocardiography (TDI).Methods: 52 stable HTx recipients without rejection or clinical heart failure underwent echocardiography with colour TDI 1-8 years (median 4 years) after HTx. Left ventricular (LV) systolic (s') and early diastolic (e') mitral annular velocities, right ventricular (RV) tricuspid annular s', RVe', as well as mitral flow velocities and LV ejection fraction (EF) were analyzed.Results: Donor age ranged from 11- 58 years. HTx recipients with grafts from donors above the median age (37 years) had significantly lower LVe' velocities, both septal and lateral and a longer E wave deceleration time (DT) than recipients with donor age < median (table). There were no significant differences in LV systolic or RV parameters, recipient age, pre-transplant graft ischemic time, aetiology of heart failure, BMI, time since HTx or exercise capacity between the groups.Conclusions: Recipients with older donor hearts have a reduced LV diastolic function compared to recipients with younger donor hearts. Although the impairment is moderate, the donor age should be taken into consideration when assessing diastolic dysfunction after HTx.

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