■阿霉素相关性心肌病(ACM)可导致需要晚期心力衰竭治疗的终末期心力衰竭。
■本研究旨在提供在机械循环支持和心脏移植的当代ACM患者的心脏移植后生存数据。
■首次接受治疗的成年人(≥18岁),在2008年10月18日至2018年10月18日期间,从器官共享联合网络确认了单器官心脏移植.可以用包括ACM在内的左心室辅助装置(LVAD)支持的心肌病亚型,扩张型心肌病(DCM),和缺血性心肌病(ICM)。进行多变量Cox回归分析以确定心肌病亚型与心脏移植后生存率之间的关联。
■该分析包括18,270例患者(357例ACM;10,662例DCM;7,251例ICM)。ACM的心脏移植接受者更年轻,包括更多的女性,并且在上市时具有较高的肺血管阻力。在研究期间的所有年份中,ACM患者在移植时的耐久LVAD百分比较低。与DCM患者相比,ACM患者心脏移植后死亡率没有增加(调整后风险比:0.96;95%置信区间:0.79至1.40;p=0.764)或ICM患者(调整后风险比:0.85;95%置信区间:0.6至1.2;p=0.304)。
■在2008年至2018年间接受心脏移植的ACM患者的心脏移植后存活率与扩张型和缺血性心肌病患者相似。与其他心肌病亚型相比,桥接移植LVAD的使用仍然较低。
UNASSIGNED: Adriamycin-associated cardiomyopathy (ACM) can lead to end-stage heart failure requiring advanced heart failure therapies.
UNASSIGNED: This study sought to provide post-cardiac transplant survival data in patients with ACM in the contemporary era of mechanical circulatory support and cardiac transplantation.
UNASSIGNED: Adults (≥18 years of age) who underwent first-time, single-organ heart transplantation were identified from the United Network for Organ Sharing between October 18, 2008, and October 18, 2018. Cardiomyopathy subtypes that could have been supported with a left ventricular assist device (LVAD) including ACM, dilated cardiomyopathy (DCM), and ischemic cardiomyopathy (ICM) were included. A multivariable Cox regression analysis was performed to determine the association between cardiomyopathy subtype and post-cardiac transplant survival.
UNASSIGNED: This analysis included 18,270 patients (357 with ACM; 10,662 with DCM; and 7,251 with ICM). Heart transplant recipients with ACM were younger, included more women, and had higher pulmonary vascular resistance at the time of listing. Patients with ACM had a lower percentage of durable LVADs at the time of transplant across all years of the study period. Patients with ACM did not experience an increase in post-cardiac transplant mortality compared to those with DCM (adjusted hazard ratio: 0.96; 95% confidence interval: 0.79 to 1.40; p = 0.764) or ICM (adjusted hazard ratio: 0.85; 95% confidence interval: 0.6 to 1.2; p = 0.304).
UNASSIGNED: Patients with ACM who received heart transplants between 2008 and 2018 had similar post-cardiac transplant survival to those with dilated and ischemic cardiomyopathy. Bridge-to-transplant LVAD use remains lower compared to other cardiomyopathy subtypes.