This is a single center retrospective/prospective observational study with additional procedures meant to evaluate molecular mechanisms underlying injury in donor's heart. The research project will focus on Metabolomics by NMR and LC-MS and ultrastructural analysis using electron microscopy of endomyocardial biopsies (EMB).In our clinical protocol of heart transplantation, myocardial biopsy samples are routinely provided at intraoperative and postoperative time.
Study Type
OBSERVATIONAL
Enrollment
14
Fondazione IRCCS Policlinico San Matteo
Pavia, Pavia, Italy
Biventricular failure: left ventricular failure (LV EF <40%) and right ventricular failure (TAPSE <16% and/or FAC < 35% and/or S' wave velocity < 10 cm/sec) within 24 hours post transplantation
Time frame: Within 24 hours post transplantation
Left ventricular dysfunction (longitudinal global strain (LGS) < -14% at 1 month and <-17% at 6 and 12 months and/or FEvsx <50%) at 1, 6, 12 months after transplant (in absence of rejection)
Time frame: At 1, 6, 12 months after transplant
Left ventricular failure (LV EF <40%) within 24 hours post transplantation
Time frame: Within 24 hours post transplantation
Right ventricular failure (TAPSE <16% and/or FAC < 35% and/or S' wave velocity < 10 cm/sec) within 24 hours post transplantation
Time frame: Within 24 hours post transplantation
Hemodynamic: Cardiac Index < 2 L/min/mq, wedge pressure >20 mmHg, right atrial pressure (RAP > 15 mmHg) within 24 hours post transplantation and at 1, 6, 12 months after transplant (in absence of rejection)
Time frame: At 1, 6, 12 months after transplant
Death for graft failure within 24 hours post transplantation
Time frame: Within 24 hours post transplantation
ECMO within 24 hours of transplant for ventricular failure
Time frame: Within 24 hours of transplant
IABP within 24 hours of transplant for ventricular failure
Time frame: Within 24 hours of transplant
Echocardiographic parameters: E/A>>1; DT<150 msec; E/e'>15, atrial strain at 1, 6, 12 months after transplant (in absence of rejection)
Time frame: At 1, 6, 12 months after transplant
Death at 1, 6, 12 months after transplant (in absence of rejection
Time frame: At 1, 6, 12 months after transplant
Trend of cardiac biomarker (BNP), trend of TNIhs, angiotensinogen, ADIPOQ, HGFAC, IGFBP3, other markers of ischaemia
Time frame: At first and third week
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