Poster Presentation
Thursday, 20 July 2006
10:00 AM - 10:30 AM
Thursday, 20 July 2006
3:00 PM - 3:30 PM
This presentation is part of : Poster Presentations II
Cardiac Allograft Vasculopathy and Steroid Therapy: Impact on Perceived Health Status and Functional Capacity in Heart Transplant Recipients
Pamela B. Sharp, MS, RN1, Kathy M. Baker, MS, RN2, Maureen P. Flattery, RN, MSN, NP3, and Jeanne Salyer, PhD, RN2. (1) Adult Health Nursing, Virginia Commonwealth University, School of Nursing, Richmond, VA, USA, (2) Adult Health Nursing, Virginia Commonwealth University, Richmond, VA, USA, (3) Transplant/CHF clinic, Virginia Commonwealth University Health System, Richmond, VA, USA
Learning Objective #1: describe the effects of steroid therapy and cardiac allograft vasculopathy on perceived health status and functional status in long term heart transplant recipients.
Learning Objective #2: describe the implications of long term steroid therapy and cardiac allograft vasculopathy on long term surveillence and education of heart transplant recipients.
Although heart transplant recipients (HTRs) report improvements in perceived health status (PHS) and functional status (calculated VO2) after transplant, the impact of corticosteroid maintenance immunosuppression (CMI) and allograft vasculopathy (CAV) on PHS and VO2 in long-term HTRs is not fully understood. The purpose of this study was to determine the independent vs additive effects of CMI and CAV on PHS and VO2 in HTRs.  95 HTRs (post-transplant = 100.3 months; SD = 50.8) from two transplant centers participated.  HTRs (age = 56.8, SD = 10.05) were primarily male (92%), Caucasian (82%), married (68%), and well-educated (45% > HS education).  20% worked full time, 40% had CAV, and 20% required CMI. PHS was measured with item #1 of the SF-36, an overall rating of health status (1 = poor, 5 = excellent).  VO2 was calculated using the 12 item Duke Activity Status Index (DASI). Summed weighted responses (metabolic equivalents) produce the DASI score used to compute VO2. A 2X4 factorial design classified patients by CMI and CAV. ANOVA included tests for CMI and CAV main effects and interactions. PHS among groups was not significantly different (F [3, 91] = 1.77, p = 0.16), with no significant interaction (F [1, 91] = 0.22, p = 0.64). There was a difference in PHS due to CMI (F [1, 91] = 5.27, p = 0.02). VO2 among groups was not significantly different (F [3, 91] = 0.01, p = 0.99), with no significant interaction (F [1, 91] = 0.03, p = 0.86). The non-significant relationship between PHS and CAV suggests that HTRs are not symptomatically burdened by CAV.  Because of multiple comorbidities associated with corticosteroid therapy, HTRs receiving CMI may perceive poorer health than those not receiving CMI. Future research aimed at evaluating interventions to prevent co-morbidities associated with CMI is warranted.

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