Key Heart Transplant Indicator May Be Different for Women

KANSAS CITY, June 8 ? When considering transplants for patients with heart failure, women may need to be evaluated differently than men.

A retrospective analysis of data from nearly 600 ambulatory heart failure patients who had cardiopulmonary exercise tests from 2000 to 2003 suggested that peak oxygen consumption during a treadmill test may need to be applied differently to women.

A threshold of 12 to 14 ml/kg/min is generally accepted as one indication that a cardiac transplant may be necessary, said Andrew Kao, M.D., of the Mid-American Heart Institute here. But this threshold, based on research in men, may be as low as 10 ml/kg/min for women.

"No study evaluating peak VO₂ has included enough women to delineate the prognostic value of peak VO2 in this population," Dr. Kao and colleagues said in the June 6 issue of the Journal of the American College of Cardiology. At the time of the analysis, Dr. Kao was with the University of Pennsylvania's Heart Failure and Transplant Ambulatory Care Center.

On average, women had a significantly lower peak VO₂ than men (14 ml/kg/min versus 16.6 mL/kg/min; P

"Because there is a relative shortage of donor organs and post-transplantation survival is limited, it is of the utmost importance that organs are allocated as appropriately as possible," the authors said.