Cardiac Changes Noted within 4 Years of Transplant in Postmortem Evaluation of a Patient with Untreated Obstructive Sleep Apnea

In this case report, the authors discuss the autopsy findings of biventricular cardiomegaly 4 years after transplantation of an otherwise normal heart in a patient who did not accept treatment for documented severe obstructive sleep apnea.

Cardiac transplantation - autopsy - obstructive sleep apnea

REFERENCES

• 1 Shojania K G et al.. Changes in rates of autopsy-detected diagnostic errors over time: a systematic review.  JAMA. 2003;  289 2849-2856
• 2 Wolk R, Shamsuzzaman A S, Somers V K. Obesity, sleep apnea, and hypertension.  Hypertension. 2003;  42 1067-1074 , Epub 2003: Nov 10
• 3 Ahmed Q, Chung-Park M, Tomashefski Jr J F. Cardiopulmonary pathology in patients with sleep apnea/obesity hypoventilation syndrome.  Hum Pathol. 1997;  28 264-269
• 4 Klink M E, Sethi G K, Copeland J G, Quan S F. Obstructive sleep apnea in heart transplant patients. A report of five cases.  Chest. 1993;  104 1090-1092
• 5 Lenner R, Padilla M L, Teirstein A S, Gass A, Schilero G J. Pulmonary complications in cardiac transplant recipients.  Chest. 2001;  120 508-513
• 6 Brilakis E S, Olson E J, McGregor C G, Olson L J. Sleep apnea in heart transplant recipients: type, symptoms, risk factors, and response to nasal continuous positive airway pressure.  J Heart Lung Transplant. 2000;  19 330-336
• 7 Cloward T V, Walker J M, Farney R J, Anderson J L. Left ventricular hypertrophy is a common echocardiographic abnormality in severe obstructive sleep apnea and reverses with nasal continuous positive airway pressure.  Chest. 2003;  124 594-601
• 8 Wilhelmi M, Pethig K, Wilhelmi M, Nguyen H, Struber M, Haverich A. Heart transplantation: echocardiographic assessment of morphology and function after more than 10 years of follow-up.  Ann Thorac Surg. 2002;  74 1075-1079 , discussion 1079
• 9 Chin C, Hunt S, Robbins R, Hoppe R, Reitz B, Bernstein D. Long-term follow-up after total lymphoid irradiation in pediatric heart transplant recipients.  J Heart Lung Transplant. 2002;  21 667-673
• 10 Roberts C A, Stern D L, Radio S J. Asymmetric cardiac hypertrophy at autopsy in patients who received FK506 (tacrolimus) or cyclosporine A after liver transplant.  Transplantation. 2002;  74 817-821
• 11 Nakata Y, Yoshibayashi M, Yonemura T et al.. Tacrolimus and myocardial hypertrophy.  Transplantation. 2000;  69 1960-1962