Heart failure & cardiomyopathiesCohort study
Donor Electrocardiogram Associations With Cardiac Dysfunction, Heart Transplant Use, and Survival
- Prospective cohort study
- multicentre
- 8 organ procurement organizations
- blinded ECG review
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
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
| Comparison | adjusted OR (95% CI) | |
|---|---|---|
| Pathological Q waves · only significant ECG predictor of nonuse | 0.39 (0.29–0.53) | |
| 0.20.5125Adjusted odds ratio (log scale) |
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. JACC Heart Fail. Published 17 January 2024. doi:10.1016/j.jchf.2023.12.007
Summarised from the published abstract; every number is checked against it