Author + information
- Received March 20, 1991
- Revision received May 23, 1991
- Accepted June 26, 1991
- Published online January 1, 1992.
- Hector O. Ventura, MD∗,
- Maryl R. Johnson, MD, FACC,
- Bonnie Grusk, RN, MSN,
- Roque Pifarre, MD, FACC and
- Maria Rosa Costanzo-Nordin, MD, FACC∗
- ↵∗Address for reprints: Maria Rosa Costanzo-Nordin, MD, Cardiac Transplant Program, Section of Cardiology, Department of Medicine, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153.
Obesity and hypertension frequently develop after heart transplantation. The cardiac adaptation to obesity and hypertension was studied by determining hemodynamic and echocardiographic indexes in 10 obese hypertensive patients (body mass index ≥27.8 kg/m2in men or ≥ 27.3 kg/m2in women) matched by mean arterial pressure, age and gender with 10 nonobese hypertensive patients 1 year after cardiac transplantation. Cardiac output was 30% greater (p < 0.02) and systemic vascular resistance 25% lower (p < 0.01) in the obese than in the nonobese patients. Right ventricular systolic and pulmonary artery systolic, diastolic and mean pressures were also significantly higher (p < 0.05) in the obese patients. Left ventricular end-diastolic diameter was 25% greater (p < 0.05), left ventricular mass 28% greater (p < 0.02) and left ventricular end-diastolic volume 20% higher (p < 0.01) in the obese subjects. Left ventricular ejection fraction was significantly lower in the obese than in the nonobese subjects (34% vs. 51%, p < 0.05).
These results indicate that the cardiac adaptation to obesity and hypertension after heart transplantation consists of left ventricular dilation and an increase in left ventricular mass associated with an increased cardiac output and lower peripheral vascular resistance. These adaptive changes that occur in obese hypertensive patients after heart transplantation might increase the long-term risk of graft failure, as suggested by their lower left ventricular ejection fraction 1 year after transplantation.
- Received March 20, 1991.
- Revision received May 23, 1991.
- Accepted June 26, 1991.