Clinical course of arrhythmogenic right ventricular cardiomyopathy with end-stage heart failure and outcome after heart transplantation

Copyright © 2022 Elsevier Masson SAS. All rights reserved..

BACKGROUND: Few data exist on the characteristics and outcomes of patients with arrhythmogenic right ventricular cardiomyopathy and advanced heart failure who undergo heart transplantation.

AIM: To explore the pretransplant course and outcomes of patients with arrhythmogenic right ventricular cardiomyopathy after heart transplantation.

METHODS: This observational retrospective monocentric study included all consecutive patients with arrhythmogenic right ventricular cardiomyopathy who underwent heart transplantation during a 13-year period (2006-2019) at Pitié-Salpêtrière University Hospital (Paris).

RESULTS: A total of 23 patients with arrhythmogenic right ventricular cardiomyopathy underwent heart transplantation between 2006 and 2019. The median time from diagnosis to heart transplantation was 9 years, and the median age at transplantation was 50 years. At diagnosis, half of the patients had left ventricular dysfunction, 59% had extensive T-wave inversion and 43% had a history of sustained ventricular tachycardia. Only five patients were involved in intensive sport activity. Indications for heart transplantation were end-stage biventricular dysfunction in 13 patients, end-stage right ventricular heart failure in seven and electrical storm in three. Only three patients had pulmonary hypertension, and half of the patients had atrial arrhythmias. The survival rate 1 year after heart transplantation was 74% (95% confidence interval 53-88%). Eight patients experienced primary graft dysfunction needing extracorporeal membrane oxygenation.

CONCLUSIONS: Patients with arrhythmogenic right ventricular cardiomyopathy who eventually needed heart transplantation mostly exhibited extended disease with biventricular dysfunction at diagnosis. Intensive sport activity did not seem to be a major determinant. Advanced heart failure usually occurred late in the course of the disease. Primary graft dysfunction after heart transplantation was frequent, and should be anticipated. Additional data are needed to identify the optimal timing for heart transplantation and predictors of end-stage heart failure in patients with arrhythmogenic right ventricular cardiomyopathy.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:116

Enthalten in:

Archives of cardiovascular diseases - 116(2023), 1 vom: 06. Jan., Seite 9-17

Sprache:

Englisch

Beteiligte Personen:

Petruescu, Laura [VerfasserIn]
Lebreton, Guillaume [VerfasserIn]
Coutance, Guillaume [VerfasserIn]
Maupain, Carole [VerfasserIn]
Fressart, Véronique [VerfasserIn]
Badenco, Nicolas [VerfasserIn]
Waintraub, Xavier [VerfasserIn]
Duthoit, Guillaume [VerfasserIn]
Laredo, Mikael [VerfasserIn]
Himbert, Caroline [VerfasserIn]
Hidden-Lucet, Francoise [VerfasserIn]
Leprince, Pascal [VerfasserIn]
Varnous, Shaida [VerfasserIn]
Gandjbakhch, Estelle [VerfasserIn]

Links:

Volltext

Themen:

ARVC
Arrhythmogenic right ventricular cardiomyopathy
Arrhythmogenic right ventricular dysplasia
Heart failure
Heart transplantation
Journal Article
Observational Study

Anmerkungen:

Date Completed 08.02.2023

Date Revised 08.02.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.acvd.2022.10.005

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM351201017