Table 3.
Differences in Hemodynamic Parameters Assessed in Patients Treated With Sirolimus Versus CNI at Time of Baseline RHC and at Last RHC Follow‐Up
| Sirolimus (n=30) | CNI (n=22) | Difference (Sirolimus–CNI) | P Value | Age‐Adjusted Estimates (95% CI) (Sirolimus vs CNI) ‡ | P Value | |
|---|---|---|---|---|---|---|
| Time from first to last RHC, y | 2.23±0.69 | 2.50±0.50 | −0.27±0.32 | 0.14 | ||
| SBP, mm Hg ±SD | ||||||
| Baseline | 127.27±15.27 | 126.83±15.44 | 0.44±8.45 | 0.93* | ||
| Follow‐up | 116.2±22.1 | 124.61±19.46 | −8.41±11.34 | 0.2* | ||
| Δ SBP/y | −6.06±10.18 | −1.50±11.29 | −4.56±5.96 | 0.17* | −2.1 (−5.49 to 1.30) | 0.22 |
| P value | 0.02 † | 0.68 † | ||||
| DBP, mm Hg ±SD | ||||||
| Baseline | 76.65±10.63 | 81.11±13.28 | −4.46±6.72 | 0.22* | ||
| Follow‐up | 71.0±9.23 | 76.72±12.07 | −5.72±6.02 | 0.08* | ||
| Δ DBP/y | −3.34±6.13 | −3.49±14.18 | 0.15±6.31 | 0.96* | +0.35 (−2.88 to 3.58) | 0.82 |
| P value | 0.03 † | 0.37 † | ||||
| MAP, mm Hg ±SD | ||||||
| Baseline | 93.52±11.02 | 96.35±13.25 | −2.83±6.79 | 0.45* | ||
| Follow‐up | 86 .10±12.10 | 92.68±13.10 | −6.58±6.97 | 0.09* | ||
| Δ MAP/y | −4.24±6.65 | −2.82±12.23 | −1.42±5.63 | 0.62* | −0.46 (−3.42 to 2.49) | 0.75 |
| P value | 0.02 † | 0.43 † | ||||
| Heart rate, BPM ±SD | ||||||
| Baseline | 85.40±13.12 | 87.68±11.18 | −2.28±6.62 | 0.51* | ||
| Follow‐up | 83.26±11.69 | 88.04±11.50 | −4.78±6.37 | 0.15* | ||
| Δ Heart rate/y | −0.51±2.50 | −0.02±1.71 | −0.49±1.14 | 0.43* | −0.54 (−1.95 to 0.86) | 0.44 |
| P value | 0.28 † | 0.85 † | ||||
| RAP, mm Hg ±SD | ||||||
| Baseline | 7.40±4.90 | 9.20±5.50 | −1.8±2.89 | 0.22* | ||
| Follow‐up | 6.40±3.46 | 8.95±6.91 | −2.55±3.14 | 0.09* | ||
| Δ RAP/y | −0.97±5.51 | 0.31±3.56 | −1.28±2.46 | 0.34* | −0.29 (−0.93 to 0.36) | 0.39 |
| P value | 0.27 † | 0.79 † | ||||
| SPAP, mm Hg ±SD | ||||||
| Baseline | 33.10±9.72 | 35.45±10.16 | −2.35±5.48 | 0.39* | ||
| Follow‐up | 29.7±7.44 | 33.73±9.20 | −4.03±4.67 | 0.09* | ||
| Δ SPAP/y | −1.72±4.73 | −0.60±3.81 | −1.12±2.32 | 0.37* | −0.40 (−1.68 to 0.86) | 0.53 |
| P value | 0.07 † | 0.41 † | ||||
| DPAP, mm Hg ±SD | ||||||
| Baseline | 13.53±6.05 | 14.41±6.99 | −0.88±3.63 | 0.63* | ||
| Follow‐up | 10.43±3.94 | 16.36±7.11 | −5.93±3.28 | 0.0003* | ||
| Δ DPAP/y | −1.72±3.39 | 0.82±2.59 | −2.54±1.62 | 0.005* | −1.20 (−2.10 to −0.29) | 0.01 |
| P value | 0.008 † | 0.17 † | ||||
| MPAP, mm Hg ±SD | ||||||
| Baseline | 22.03±6.90 | 23.68±6.97 | −1.65±3.81 | 0.4* | ||
| Follow‐up | 19.07±4.72 | 23.77±7.32 | −4.70±3.49 | 0.007* | ||
| Δ MPAP/y | −1.51±3.23 | −0.01±2.95 | −1.5±1.68 | 0.09* | −0.69 (−1.61 to 0.22) | 0.13 |
| P value | 0.02 † | 0.95 † | ||||
| PCWP, mm Hg ±SD | ||||||
| Baseline | 12.52±5.45 | 12.27±4.88 | 0.25±2.82 | 0.87* | ||
| Follow‐up | 9.90±3.25 | 12.77±6.10 | −2.87±2.80 | 0.03* | ||
| Δ PCWP/y | −1.50±2.59 | 0.20±2.20 | −1.70±1.30 | 0.02* | −0.86 (−1.58 to −0.14) | 0.02 |
| P value | 0.02 † | 0.67 † | ||||
| Cardiac output, L/min ±SD | ||||||
| Baseline | 6.0±1.55 | 5.80±1.34 | 0.20±0.78 | 0.72* | ||
| Follow‐up | 6.40±1.18 | 6.30±1.46 | 0.10±0.74 | 0.74* | ||
| Δ Cardiac output/y | 0.14±0.96 | 0.22±0.46 | −0.08±0.39 | 0.75* | −0.05 (−0.32 to 0.20) | 0.67 |
| P value | 0.13 † | 0.09 † | ||||
| Cardiac index, L/min per m2 ±SD | ||||||
| Baseline | 3.17±0.74 | 2.93±0.57 | 0.24±0.35 | 0.23* | ||
| Follow‐up | 3.22±0.59 | 3.02±0.70 | 0.2±0.36 | 0.27* | ||
| Δ Cardiac index/y | 0.02±0.48 | 0.09±0.24 | −0.07±0.19 | 0.59* | −0.05 (−0.18 to 0.08) | 0.44 |
| P value | 0.46 † | 0.24 † | ||||
| DPG±SD | ||||||
| Baseline | 1.10±4.32 | 2.14±5.03 | −1.04±2.60 | 0.43* | ||
| Follow‐up | 0.31±3.20 | 3.59±4.43 | −3.28±2.17 | 0.003* | ||
| Δ DPG/y | −0.34±2.56 | 0.62±2.51 | −0.96±1.39 | 0.19* | −0.38 (−1.12 to 0.36) | 0.30 |
| P value | 0.42 † | 0.34 † | ||||
CNI indicates calcineurin inhibitor; DBP, diastolic blood pressure; DPAP, diastolic pulmonary artery pressure; DPG, diastolic pulmonary gradient; MAP, mean arterial pressure; MPAP, mean pulmonary artery pressure; PCWP, pulmonary capillary wedge pressure; RAP, right atrial pressure; RHC, right heart catheterization; SBP, systolic blood pressure; and SPAP, systolic pulmonary artery pressure.
*
t test.
†
Paired t test.
‡
β estimates of sirolimus conversion after adjustment for age at the time of heart transplant.