(1) Background: In the mHeart trial, we showed that an eHealth intervention, mHeart, improved heart transplant (HTx) recipients' adherence to immunosuppressive therapy compared with the standard of care. Herein, we present the analysis assessing whether mHeart reduces complication frequency and healthcare resource use, and whether this reduction depends on patients' adherence. (2) Methods: The mHeart was a single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were mortality, complications, and resource use during follow-up (mean 1.6 ± 0.6 years). (3) Results: A significantly lower proportion of HTx recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; = 0.02), cardiovascular events (0.35% vs. 2.4%; = 0.006), infections (17.2% vs. 56%; = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; = 0.03) than controls. In addition, a significantly lower proportion of patients in the intervention needed hospital (32.4% vs. 56.9%; = 0.004) or urgent admissions (16.9% vs. 41.4%; = 0.002) and emergency room visits (50.7% vs. 69.0%; = 0.03). Adherence status (measured by the self-reported SMAQ) influenced only controls regarding hospitalizations and emergency room visits. Differences were not significant on deaths (intervention 4.2% vs. control 9.5%; = 0.4) (4) Conclusions: the mHeart strategy significantly reduced the occurrence of the studied post-transplant complications and the need for medical attention in HTx recipients. Adherence status influenced controls in their need for medical care.
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http://dx.doi.org/10.3390/jcdd10020077 | DOI Listing |
Transpl Immunol
January 2025
University of Zagreb School of Medicine, Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Šalata 3, Zagreb, Croatia. Electronic address:
Introduction: While lymphodepletion is considered a therapeutic effect of rabbit anti-thymocyte globulin (rATG), a concomitant decrease in basophil count (BC) has unknown clinical effect.
Objective: To investigate the association between BC following rATG induction and acute cellular rejection (ACR) during the first post-HTx year.
Methods: Retrospective single-center study included 183 HTx recipients receiving rATG induction between 2010 and 2021 (mean age 52 ± 13 years, 23 % female).
Circ Cardiovasc Imaging
January 2025
Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis (OLV) Clinic, Aalst, Belgium (M. Belmonte, P.P., M.M.V., M. Beles, H.O., R.S., G.E., M.S., R.D., W.H., J.V.K., J.B., M.V.).
Background: Coronary computed tomography angiography (CCTA) is emerging as a valuable tool for noninvasive surveillance of cardiac allograft vasculopathy (CAV) in patients with heart transplant (HTx). We assessed the diagnostic performance of a comprehensive CCTA-based approach compared with the invasive reference, which includes invasive coronary angiography, intravascular ultrasound, and fractional flow reserve, for detecting CAV.
Methods: This was a multicenter prospective study including 37 patients with HTx who underwent CCTA, invasive coronary angiography, intravascular ultrasound, and fractional flow reserve.
J Cardiovasc Dev Dis
December 2024
Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Aims: Patients after heart transplantation (HTX) often experience post-transplant bradycardia, but little is known about the outcomes of early pacemaker dependency after HTX. We compared post-transplant mortality, graft failure, and the requirement for the permanent pacemaker implantation of patients with and without early pacemaker dependency after HTX.
Methods: We screened all adult patients for early pacemaker dependency after HTX (defined as immediately after surgery) who underwent HTX at Heidelberg Heart Center between 1989 and 2022.
Intensive Care Med Exp
November 2024
Critical Care Research Group, The Prince Charles Hospital, Level 3, Clinical Sciences Building, Chermside Qld 4032, Brisbane, QLD, Australia.
Physiol Res
November 2024
Dept Cardiovasc Surgery, Inst Clin Exp Med, Prague, Czech Republic.
An important complication of prolonged support of the left ventricle with an assist device when implanted in patients with heart failure is unloading-induced cardiac atrophy. Our recent study suggested that sex-linked differences in the development of atrophy induced by heterotopic heart transplantation (HTX) do exist, however, the role of the environmental conditions dependent on plasma concentrations of sex hormones remains elusive. We aimed to compare the course of HTX-induced cardiac atrophy in male and female rats after gonadectomy with substitution of steroid hormones of the opposite sex.
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