{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T21:13:15Z","timestamp":1788988395917,"version":"build-2803163510"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of donor left ventricular ejection fraction (LVEF) at heart procurement has been extensively studied. However, there remain scarce data on how 1-year post-heart transplant (HTx) LVEF affects recipient outcomes. Our study seeks to address this gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>The OPTN database was analyzed for adult orthotopic HTx recipients between 2010\u20132022. Patients with missing LVEF data during their 1-year follow-up were excluded. Recipients were stratified into four groups based on their 1-year LVEF: preserved:\u2009\u2265\u200950%, mildly reduced: 40\u201349%, moderately reduced: 30\u201339%, and severely reduced:\u2009&lt;\u200930%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 23,629 recipients were included in this analysis. Patients with a reduced 1-year LVEF had higher hospitalization rates, as well as acute graft rejection and renal failure necessitating dialysis in the postoperative and subacute period. There was an incremental increase in all-cause mortality as LVEF decreased: mildly reduced (HR\u2009=\u20091.28,\n                      <jats:italic>p\u2009=\u2009<\/jats:italic>\n                      0.011), moderately reduced (HR\u2009=\u20091.90,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and severely reduced (HR\u2009=\u20092.06,\n                      <jats:italic>p\u2009=\u2009<\/jats:italic>\n                      0.002). Cardiovascular-related mortality had parallel findings. Similarly, recipients with a reduced 1-year LVEF had a progressive increase in their CAV risk: mildly reduced (sHR\u2009=\u20091.28,\n                      <jats:italic>p\u2009=\u2009<\/jats:italic>\n                      0.005), moderately reduced (sHR\u2009=\u20091.57,\n                      <jats:italic>p\u2009=\u2009<\/jats:italic>\n                      0.004), and severely reduced (sHR\u2009=\u20091.65,\n                      <jats:italic>p\u2009=\u2009<\/jats:italic>\n                      0.025).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Recipients with mild, moderate, and severe reductions in 1-year LVEF had higher rates of hospitalization, renal failure, and acute rejection, as well as a significant increase in mortality and CAV risk independent of other clinically relevant variables. The clinical implications of our findings suggest that LVEF 1-year after HTx is a powerful prognostic indicator that can allow clinicians to identify high-risk recipients, screen for comorbidities, and treat or manage subsequent pathologic processes timely.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-03022-1","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:26:39Z","timestamp":1788942399000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic implications of one-year left ventricular systolic function after heart transplantation"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6223-0731","authenticated-orcid":false,"given":"Ahad","family":"Firoz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imo","family":"Ebong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Cadeiras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaqing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"issue":"5","key":"3022_CR1","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1016\/j.jtcvs.2018.07.115","volume":"157","author":"A Sibona","year":"2019","unstructured":"Sibona A, Khush KK, Oyoyo UE et al (2019) Long-term transplant outcomes of donor hearts with left ventricular dysfunction. J Thorac Cardiovasc Surg 157(5):1865\u20131875","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"8","key":"3022_CR2","doi-asserted-by":"publisher","first-page":"e14988","DOI":"10.1111\/ctr.14988","volume":"37","author":"A Firoz","year":"2023","unstructured":"Firoz A, Yanagida R, Hamad E, Kashem M, Toyoda Y (2023) Impact of donor ventricular function on heart transplantation outcomes. Clin Transplant 37(8):e14988","journal-title":"Clin Transplant"},{"issue":"1","key":"3022_CR3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.21037\/acs.2017.09.09","volume":"7","author":"KK Khush","year":"2018","unstructured":"Khush KK (2018) Donor selection in the modern era. Ann Cardiothorac Surg 7(1):126\u2013134","journal-title":"Ann Cardiothorac Surg"},{"issue":"5","key":"3022_CR4","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.healun.2022.10.015","volume":"42","author":"A Velleca","year":"2023","unstructured":"Velleca A, Shullo MA, Dhital K et al (2023) The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients. J Heart Lung Transplant 42(5):e1\u2013e141","journal-title":"J Heart Lung Transplant"},{"issue":"12","key":"3022_CR5","doi-asserted-by":"publisher","first-page":"2338","DOI":"10.3390\/diagnostics11122338","volume":"11","author":"D Masarone","year":"2021","unstructured":"Masarone D, Kittleson M, Gravino R, Valente F, Petraio A, Pacileo G (2021) The role of echocardiography in the management of heart transplant recipients. Diagnostics (Basel) 11(12):2338","journal-title":"Diagnostics (Basel)"},{"issue":"446","key":"3022_CR6","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","volume":"94","author":"JP Fine","year":"1999","unstructured":"Fine JP, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94(446):496\u2013509","journal-title":"J Am Stat Assoc"},{"issue":"1","key":"3022_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","volume":"28","author":"RM Lang","year":"2015","unstructured":"Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1):1-39.e14","journal-title":"J Am Soc Echocardiogr"},{"issue":"7","key":"3022_CR8","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1016\/j.echo.2019.12.016","volume":"33","author":"P Angaran","year":"2020","unstructured":"Angaran P, Dorian P, Ha ACT et al (2020) Association of left ventricular ejection fraction with mortality and hospitalizations. J Am Soc Echocardiogr 33(7):802-811.e6","journal-title":"J Am Soc Echocardiogr"},{"issue":"4","key":"3022_CR9","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/S0735-1097(03)00789-7","volume":"42","author":"JP Curtis","year":"2003","unstructured":"Curtis JP, Sokol SI, Wang Y et al (2003) The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol 42(4):736\u2013742","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"3022_CR10","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s10741-019-09806-0","volume":"24","author":"Z Ge","year":"2019","unstructured":"Ge Z, Li A, McNamara J, Dos Remedios C, Lal S (2019) Pathogenesis and pathophysiology of heart failure with reduced ejection fraction: translation to human studies. Heart Fail Rev 24(5):743\u2013758","journal-title":"Heart Fail Rev"},{"issue":"4","key":"3022_CR11","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/S1053-2498(00)00231-X","volume":"20","author":"RE Hershberger","year":"2001","unstructured":"Hershberger RE, Ni H, Toy W, Wilson RA (2001) Distribution and declines in cardiac allograft radionuclide left ventricular ejection fractions in relation to late mortality. J Heart Lung Transplant 20(4):417\u2013424","journal-title":"J Heart Lung Transplant"},{"issue":"4","key":"3022_CR12","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1093\/oxfordjournals.eurheartj.a015317","volume":"18","author":"M Barbir","year":"1997","unstructured":"Barbir M, Lazem F, Banner N, Mitchell A, Yacoub M (1997) The prognostic significance of non-invasive cardiac tests in heart transplant recipients. Eur Heart J 18(4):692\u2013696","journal-title":"Eur Heart J"},{"issue":"2","key":"3022_CR13","doi-asserted-by":"publisher","first-page":"e14881","DOI":"10.1111\/ctr.14881","volume":"37","author":"M Lai","year":"2023","unstructured":"Lai M, Aras MA, Park M (2023) Post-transplant ejection fraction and renal failure in cardiac transplant recipients: an analysis of the OPTN database. Clin Transplant 37(2):e14881","journal-title":"Clin Transplant"},{"issue":"5","key":"3022_CR14","doi-asserted-by":"publisher","first-page":"392","DOI":"10.7861\/clinmed.2019-0195","volume":"19","author":"TA Chowdhury","year":"2019","unstructured":"Chowdhury TA (2019) Post-transplant diabetes mellitus. Clin Med (Lond) 19(5):392\u2013395","journal-title":"Clin Med (Lond)"},{"issue":"3","key":"3022_CR15","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.healun.2021.11.017","volume":"41","author":"S Shoji","year":"2022","unstructured":"Shoji S, Kuno T, Kohsaka S et al (2022) Incidence and long-term outcome of heart transplantation patients who develop postoperative renal failure requiring dialysis. J Heart Lung Transplant 41(3):356\u2013364","journal-title":"J Heart Lung Transplant"},{"issue":"4","key":"3022_CR16","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/j.trsl.2012.01.018","volume":"159","author":"CA Labarrere","year":"2012","unstructured":"Labarrere CA, Jaeger BR (2012) Biomarkers of heart transplant rejection: the good, the bad, and the ugly! Transl Res 159(4):238\u2013251","journal-title":"Transl Res"},{"issue":"5","key":"3022_CR17","first-page":"506","volume":"15","author":"D McNamara","year":"1996","unstructured":"McNamara D, Di Salvo T, Mathier M, Keck S, Semigran M, Dec GW (1996) Left ventricular dysfunction after heart transplantation: incidence and role of enhanced immunosuppression. J Heart Lung Transplant 15(5):506\u2013515","journal-title":"J Heart Lung Transplant"},{"key":"3022_CR18","unstructured":"Ludhwani D, Abraham J, Sharma S, Kanmanthareddy A (2024) Heart transplantation rejection. In: StatPearls. StatPearls Publishing"},{"key":"3022_CR19","doi-asserted-by":"crossref","unstructured":"Mehta A, DeFilippis EM, Stehlik J, Jackson AM, Kobashigawa JA, Shah P. Contemporary Antibody-mediated rejection in heart transplantation: JACC: Heart failure position statement. JACC Heart Fail. Published online August 21, 2025","DOI":"10.1016\/j.jchf.2025.102614"},{"issue":"11","key":"3022_CR20","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1016\/j.healun.2019.08.005","volume":"38","author":"JM Van Keer","year":"2019","unstructured":"Van Keer JM, Van Aelst LNL, Rega F et al (2019) Long-term outcome of cardiac allograft vasculopathy: importance of the International Society for Heart and Lung Transplantation angiographic grading scale. J Heart Lung Transplant 38(11):1189\u20131196","journal-title":"J Heart Lung Transplant"},{"issue":"1","key":"3022_CR21","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s40472-019-00257-y","volume":"7","author":"MH Barghash","year":"2020","unstructured":"Barghash MH, Pinney SP (2020) Heart retransplantation: candidacy, outcomes, and management. Curr Transplant Rep 7(1):12\u201317","journal-title":"Curr Transplant Rep"},{"issue":"3","key":"3022_CR22","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.healun.2024.11.016","volume":"44","author":"BS Kadosh","year":"2018","unstructured":"Kadosh BS, Patel SS, Sidhu SK et al (2018) Waitlist mortality for patients with cardiac allograft vasculopathy under the 2018 OPTN donor heart allocation system. J Heart Lung Transplant 44(3):378\u2013385","journal-title":"J Heart Lung Transplant"},{"issue":"5","key":"3022_CR23","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/S1010-7940(03)00096-4","volume":"23","author":"B Radovancevic","year":"2003","unstructured":"Radovancevic B, Radovancevic R, Vrtovec B, Thomas CD, Frazier OH (2003) Outcomes in patients with low left ventricular ejection fraction after heart transplantation. Eur J Cardiothorac Surg 23(5):743\u2013747","journal-title":"Eur J Cardiothorac Surg"},{"issue":"10","key":"3022_CR24","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1016\/j.jcmg.2018.06.019","volume":"11","author":"M Olymbios","year":"2018","unstructured":"Olymbios M, Kwiecinski J, Berman DS, Kobashigawa JA (2018) Imaging in heart transplant patients. JACC Cardiovasc Imaging 11(10):1514\u20131530","journal-title":"JACC Cardiovasc Imaging"},{"issue":"9","key":"3022_CR25","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1111\/j.1600-6143.2007.01902.x","volume":"7","author":"MR Johnson","year":"2007","unstructured":"Johnson MR, Aaronson KD, Canter CE et al (2007) Heart retransplantation. Am J Transplant 7(9):2075\u20132081","journal-title":"Am J Transplant"},{"issue":"6","key":"3022_CR26","doi-asserted-by":"publisher","first-page":"562","DOI":"10.3325\/cmj.2014.55.562","volume":"55","author":"B Skori\u0107","year":"2014","unstructured":"Skori\u0107 B, \u010cike\u0161 M, Ljubas Ma\u010dek J et al (2014) Cardiac allograft vasculopathy: diagnosis, therapy, and prognosis. Croat Med J 55(6):562\u2013576","journal-title":"Croat Med J"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-026-03022-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-026-03022-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-026-03022-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T21:02:14Z","timestamp":1788987734000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-026-03022-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":26,"alternative-id":["3022"],"URL":"https:\/\/doi.org\/10.1007\/s00392-026-03022-1","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"assertion":[{"value":"18 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"None.","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}