Heart failure & cardiomyopathies

Donor Electrocardiogram Associations With Cardiac Dysfunction, Heart Transplant Use, and Survival: The Donor Heart Study

JACC Heart FailPublished Prospective cohort study

Authors' conclusion

ECG abnormalities are common in potential heart donors but often resolve on serial testing. Pathologic Q waves are associated with a lower likelihood of use for HT, but they do not portend worse graft survival.

Study context

Population
Potential cardiac organ donors after brain death, US, 2015–2020 (Donor Heart Study)4,136 with interpretable electrocardiograms (ECGs)
Participants
4,333 donors
Outcome
Prevalence of ECG abnormalities and their associations with cardiac dysfunction, use for heart transplantation (HT) and recipient outcomes
Methodological detailsmulticentre, 8 organ procurement organizations, blinded ECG review
  • Multicentre
  • 8 organ procurement organizations
  • Blinded ECG review

Main finding

As reported in the abstract

ECG abnormalities on initial ECG
Clinically abnormal ECG
64%
Nonspecific ST-T-wave abnormality
39%
T-wave inversion
19%
QTc interval >500 ms
17%
Conduction abnormalities, ectopy, pathologic Q waves, ST-segment elevations (each); resolved on repeat ECGs in most cases
≤5%

Observational data: associations, not effects.

Further findings

Donor heart nonuse by pathological Q waves

Adjusted OR (95% CI)
Pathological Q wavesOnly significant ECG predictor of nonuse0.39 (0.29–0.53)

Graft survival · 1 year post-HT

No ECG abnormality associated with graft survival

Original publication

Donor Electrocardiogram Associations With Cardiac Dysfunction, Heart Transplant Use, and Survival: The Donor Heart Study. JACC Heart Fail. Published 17 January 2024. doi:10.1016/j.jchf.2023.12.007

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