Showing papers by "John P. Boehmer published in 1998"

Heart transplant coronary artery disease detected by coronary angiography: A multiinstitutional study of preoperative donor and recipient risk factors

Abstract: Background: Controversy exists regarding donor and recipient factors that promote the development and progression of coronary artery disease after heart transplantation and the likelihood of coronary artery disease causing death or retransplantation Methods: To investigate this issue in a large cohort of patients, we analyzed 5963 postoperative angiograms performed in 2609 of the 3837 patients undergoing heart transplantation at 39 institutions between January 1990 and December 1994 Coronary artery disease was classified as mild, moderate, or severe on the basis of left main involvement, primary vessel stenoses, and branch stenoses Coronary artery disease was considered severe if left main stenosis was > 70% or 2 or more primary vessels stenoses were > 70% or branch stenoses were > 70% in all 3 systems Results: By the end of 5 years after heart transplantation, coronary artery disease was present in 42% of the patients, mild in 27%, moderate in 8%, and severe in 7% Coronary artery disease-related events (death or retransplantation) had an actuarial incidence of 7% at 5 years and occurred in 2 of 3 of the patients with development of angiographically severe coronary artery disease By multivariable logistic analysis, risk factors for donor coronary artery disease included older donor age (P <0001) and donor hypertension (P =0002) By multivariable analysis in the hazard function domain, risk factors identified for the earlier onset of allograft coronary artery disease included older donor age (P <0001), donor male sex (P =0006), donor hypertension (P =07), recipient male sex (P =02), and recipient black race (P =01 ) The actuarial incidence of severe coronary artery disease was 9% at 5 years Conclusions: Angiographic coronary artery disease is very common after heart transplantation, occurring in approximately 42% of the patients by 5 years Older donor age, donor hypertension, and male donor or recipient predict earlier onset of angiographic allograft coronary artery disease Although severe angiographic allograft coronary artery disease occurs in only 7% of the patients at 5 years, its presence is highly predictive of subsequent coronary artery disease-related events or retransplantation J Heart Lung Transplant 1998;17:744-53

A noninvasive method for estimating cardiac output using lung to finger circulation time of oxygen.

Abstract: To develop a safe, noninvasive, simple, inexpensive, and clinically adaptable method for estimating cardiac output, we evaluated the potential of lung to finger circulation time (LFCT) and buildup time (Tb) of oxygen as measured by pulse oximetry to estimate cardiac output. Significant correlation was found between cardiac output as measured by thermodilution and the inverse of LFCT (R = 0.76, p < 0.001, SEE = 0.9 L/min) as well as the inverse of Tb (R = 0.72, p < 0.001, SEE = 0.9 L/min).