Symptom complex is associated with transplant coronary artery disease and sudden death/resuscitated sudden death in pediatric heart transplant recipients

Jack F. Price, Jeffrey Towbin, William J. Dreyer, Branislav Radovancevic, Howard M. Rosenblatt, Sarah K. Clunie, Susan W. Denfield

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Transplant coronary artery disease (TCAD) is a common sequela of heart transplantation. Symptom complexes associated with TCAD have not been well described. The purpose of this study was to determine if somatic complaints are associated with TCAD in pediatric heart transplant recipients. Methods: We reviewed the medical records of all patients who underwent heart transplantation at our institution from November 1984 to December 2000. TCAD was defined as any interval narrowing of coronary arteries by angiography since the previous study or at least 50% luminal obstruction of 1 or more coronary arteries by histologic examination of explanted or autopsied hearts. Results: Ninety-nine patients received heart transplants, and follow-up data were available in 80. Sixty-six patients met study criteria. Complaints of abdominal (82%), chest (45%), abdominal and chest (27%), and arm (9%) pain were made by 22 (33%) of 66 patients, and TCAD was present in 27 (41%). Of the 22 patients with pain, TCAD was present in 18, for a positive predictive value of 82% (95% confidence interval [CI] 60%-95%). The relative risk of TCAD being present in patients with a history of pain was 4 times that of patients without pain (p < 0.001). Sudden death or resuscitated sudden death occurred in 15 (68%) of 22 patients with pain vs 4 (9%) of 44 without pain (p < 0.001). Conclusions: The symptom complex of abdominal, chest and/or arm pain is strongly associated with the presence of TCAD and sudden death or resuscitated sudden death in pediatric heart transplant recipients.

Original languageEnglish (US)
Pages (from-to)1798-1803
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume24
Issue number11
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

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Sudden Death
Coronary Artery Disease
Pediatrics
Transplants
Pain
Thorax
Heart Transplantation
Coronary Vessels
Arm
Transplant Recipients
Coronary Angiography
Medical Records
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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Symptom complex is associated with transplant coronary artery disease and sudden death/resuscitated sudden death in pediatric heart transplant recipients. / Price, Jack F.; Towbin, Jeffrey; Dreyer, William J.; Radovancevic, Branislav; Rosenblatt, Howard M.; Clunie, Sarah K.; Denfield, Susan W.

In: Journal of Heart and Lung Transplantation, Vol. 24, No. 11, 01.01.2005, p. 1798-1803.

Research output: Contribution to journalArticle

Price, Jack F. ; Towbin, Jeffrey ; Dreyer, William J. ; Radovancevic, Branislav ; Rosenblatt, Howard M. ; Clunie, Sarah K. ; Denfield, Susan W. / Symptom complex is associated with transplant coronary artery disease and sudden death/resuscitated sudden death in pediatric heart transplant recipients. In: Journal of Heart and Lung Transplantation. 2005 ; Vol. 24, No. 11. pp. 1798-1803.
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abstract = "Background: Transplant coronary artery disease (TCAD) is a common sequela of heart transplantation. Symptom complexes associated with TCAD have not been well described. The purpose of this study was to determine if somatic complaints are associated with TCAD in pediatric heart transplant recipients. Methods: We reviewed the medical records of all patients who underwent heart transplantation at our institution from November 1984 to December 2000. TCAD was defined as any interval narrowing of coronary arteries by angiography since the previous study or at least 50{\%} luminal obstruction of 1 or more coronary arteries by histologic examination of explanted or autopsied hearts. Results: Ninety-nine patients received heart transplants, and follow-up data were available in 80. Sixty-six patients met study criteria. Complaints of abdominal (82{\%}), chest (45{\%}), abdominal and chest (27{\%}), and arm (9{\%}) pain were made by 22 (33{\%}) of 66 patients, and TCAD was present in 27 (41{\%}). Of the 22 patients with pain, TCAD was present in 18, for a positive predictive value of 82{\%} (95{\%} confidence interval [CI] 60{\%}-95{\%}). The relative risk of TCAD being present in patients with a history of pain was 4 times that of patients without pain (p < 0.001). Sudden death or resuscitated sudden death occurred in 15 (68{\%}) of 22 patients with pain vs 4 (9{\%}) of 44 without pain (p < 0.001). Conclusions: The symptom complex of abdominal, chest and/or arm pain is strongly associated with the presence of TCAD and sudden death or resuscitated sudden death in pediatric heart transplant recipients.",
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T1 - Symptom complex is associated with transplant coronary artery disease and sudden death/resuscitated sudden death in pediatric heart transplant recipients

AU - Price, Jack F.

AU - Towbin, Jeffrey

AU - Dreyer, William J.

AU - Radovancevic, Branislav

AU - Rosenblatt, Howard M.

AU - Clunie, Sarah K.

AU - Denfield, Susan W.

PY - 2005/1/1

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N2 - Background: Transplant coronary artery disease (TCAD) is a common sequela of heart transplantation. Symptom complexes associated with TCAD have not been well described. The purpose of this study was to determine if somatic complaints are associated with TCAD in pediatric heart transplant recipients. Methods: We reviewed the medical records of all patients who underwent heart transplantation at our institution from November 1984 to December 2000. TCAD was defined as any interval narrowing of coronary arteries by angiography since the previous study or at least 50% luminal obstruction of 1 or more coronary arteries by histologic examination of explanted or autopsied hearts. Results: Ninety-nine patients received heart transplants, and follow-up data were available in 80. Sixty-six patients met study criteria. Complaints of abdominal (82%), chest (45%), abdominal and chest (27%), and arm (9%) pain were made by 22 (33%) of 66 patients, and TCAD was present in 27 (41%). Of the 22 patients with pain, TCAD was present in 18, for a positive predictive value of 82% (95% confidence interval [CI] 60%-95%). The relative risk of TCAD being present in patients with a history of pain was 4 times that of patients without pain (p < 0.001). Sudden death or resuscitated sudden death occurred in 15 (68%) of 22 patients with pain vs 4 (9%) of 44 without pain (p < 0.001). Conclusions: The symptom complex of abdominal, chest and/or arm pain is strongly associated with the presence of TCAD and sudden death or resuscitated sudden death in pediatric heart transplant recipients.

AB - Background: Transplant coronary artery disease (TCAD) is a common sequela of heart transplantation. Symptom complexes associated with TCAD have not been well described. The purpose of this study was to determine if somatic complaints are associated with TCAD in pediatric heart transplant recipients. Methods: We reviewed the medical records of all patients who underwent heart transplantation at our institution from November 1984 to December 2000. TCAD was defined as any interval narrowing of coronary arteries by angiography since the previous study or at least 50% luminal obstruction of 1 or more coronary arteries by histologic examination of explanted or autopsied hearts. Results: Ninety-nine patients received heart transplants, and follow-up data were available in 80. Sixty-six patients met study criteria. Complaints of abdominal (82%), chest (45%), abdominal and chest (27%), and arm (9%) pain were made by 22 (33%) of 66 patients, and TCAD was present in 27 (41%). Of the 22 patients with pain, TCAD was present in 18, for a positive predictive value of 82% (95% confidence interval [CI] 60%-95%). The relative risk of TCAD being present in patients with a history of pain was 4 times that of patients without pain (p < 0.001). Sudden death or resuscitated sudden death occurred in 15 (68%) of 22 patients with pain vs 4 (9%) of 44 without pain (p < 0.001). Conclusions: The symptom complex of abdominal, chest and/or arm pain is strongly associated with the presence of TCAD and sudden death or resuscitated sudden death in pediatric heart transplant recipients.

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