Heart failure & cardiomyopathies

Patterns of Left Ventricular Regional Wall Motion Abnormalities After Brain Death and Their Clinical Significance

JACC Heart FailPublished Secondary analysis of the Donor Heart Study

Authors' conclusion

Left ventricular dysfunction after brain death exhibits distinct RWMA phenotypes, which differ in terms of selected biomarkers and LVEF, but not in recipient survival of the hearts accepted for transplantation.

Study context

Population
Potential heart donors after brain death with any regional wall motion abnormality (RWMA) on TTE913 initial TTEs analysed
Participants
4,333 donors
Comparison
RWMA phenotypes after brain death
  • Focal basal septal (FBS)n = 500
  • Basal and midventricularn = 311
  • Apicaln = 66
  • Global hypokinesisn = 36
Primary endpoint
RWMA phenotypes and their associations with donor characteristics, heart use and recipient survival
Methodological detailsmachine learning (k-means clustering)
  • Machine learning (k-means clustering)

Primary result

As reported in the abstract

RWMA phenotypes
GroupHeart acceptance for transplantation
FBS68%

FBS

Heart acceptance for transplantation68%
FBS had the highest donor heart acceptance
68%

Further findings

Left ventricular ejection fraction (LVEF) on subsequent TTEs

All phenotypes showed significant improvement in LVEF (314 donors with subsequent TTE)

Recipient survival (accepted hearts)

No significant differences by RWMA phenotype

Original publication

Patterns of Left Ventricular Regional Wall Motion Abnormalities After Brain Death and Their Clinical Significance. JACC Heart Fail. Published 26 June 2025. doi:10.1016/j.jchf.2025.102511

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