Supplementary Table 1. Clinical characteristics of study subjects categorized according to peak VO2
value
Peak VO2
(ml/kg/min)
< 21.1 (N=27)
≥ 21.1
(N=27) p-value
Clinical characteristics
Age (years) 51 ± 14 46 ± 15 0.259
Male sex 17 (63%) 22 (81%) 0.224
Follow up duration (months) 36 ± 14 32 ± 14 0.286
BMI (kg/m2) 23.0 ± 3.2 23.5 ± 3.3 0.580
Height (cm) 164.4 ± 8.1 167.3 ± 5.6 0.137
NYHA class (%) 0.471
I 25 (93%) 27 (100%)
II 2 (7%) 0 (0%)
Donor characteristics
Age (years) 40 ± 11 41 ± 8 0.933
Male sex (n, %) 18 (67%) 14 (52%) 0.406
BMI (kg/m2) 24.3 ± 3.3 23.9 ± 3.6 0.681
Height (cm) 167.9 ± 8.7 165.6 ± 8.4 0.329
LV EF (%) 61.4 ± 6.8 62.7 ± 9.0 0.555
Etiology (n, %) 0.080
Ischemic CMP 6 (22%) 5 (19%)
Non-ischemic CMP
DCMP 8 (30%) 15 (56%)
HCMP 3 (11%) 4 (15%)
VHD 7 (26%) 0 (0%)
Others 3 (11%) 3 (11%)
Comobidites (n, %)
Hypertension 18 (67%) 14 (52%) 0.406
Diabetes 17 (63%) 14 (52%) 0.582
CKD 13 (48%) 10 (37%) 0.582
Medication (n, %)
Mycophenolate 22 (82%) 25 (93%) 0.418
Tacrolimus 25 (93%) 27 (100%) 0.471
Cyclosporin 2 (7%) 0 (0%) 0.471
Everolimus 5 (19%) 2 (7%) 0.418
Prednisolone 14 (52%) 13 (48%) >0.999
RAS inhibitors 2 (7%) 0 (0%) 0.471
Beta-blockers 3 (11%) 0 (0%) 0.235
CCBs 10 (37%) 9 (33%) >0.999
Diuretics 2 (7%) 3 (11%) >0.999
Statins 20 (74%) 24 (89%) 0.293
Data are presented as mean ± SD or n (%)
BSA, body surface area; BMI, body mass index; NYHA, New-York Heart Association; CMP, cardiomyopathy; DCMP, dilated cardiomyopathy; HCMP, hypertrophic cardiomyopathy; HF, heart failure; CKD, chronic kidney disease; RAS, renin-angiotensin-aldosterone system; CCBs, calcium- channel blockers.
Supplementary Table 2. Laboratory, hemodynamic and imaging findings of study subjects categorized according to peak VO2 value
Peak VO2
(ml/kg/min)
< 21.1 (N=27)
≥ 21.1
(N=27) p-value
Laboratory findings
Hemoglobin (g/dL) 12.0 ± 2.1 13.1 ± 1.4 0.032
BUN (mg/dL) 23.1 ± 9.4 19.0 ± 5.6 0.058
eGFR (ml/min/1.73m2) 70.2 ± 18.1 78.0 ± 13.5 0.085
NT-proBNP (pg/mL) 366 [134, 681] 232 [148, 317] 0.137
Echocardiographic parameters
LVEDD (mm) 43.9 ± 3.3 43.5 ± 4.7 0.714
LV EF (%) 66.8 ± 5.1 67.8 ± 6.7 0.539
LAVI (ml/m2) 43.9 ± 19.8 40.6 ± 10.8 0.454
E/e’ 10.6 ± 4.5 10.1 ± 1.8 0.627
RV systolic pressure (mmHg) 30.3 ± 7.4 27.4 ± 5.7 0.179 Right-sided Cardiac catheterization
PCWP (mmHg) 10.3 ± 6.0 7.4 ± 3.6 0.047
Pulmonary arterial pressure (systolic)
(mmHg) 24.6 ± 9.0 19.6 ± 6.2 0.023
Pulmonary arterial pressure (mean)
(mmHg) 15.9 ± 6.4 12.4 ± 4.9 0.032
RV systolic pressure (mmHg) 26.1 ± 8.0 22.6 ± 6.1 0.079
Central venous pressure (mmHg) 3.8 ± 3.7 2.0 ± 2.5 0.042
Non-invasive central hemodynamic measurements
Quality index (%) 97.0 ± 3.6 98.3 ± 2.4 0.124
Central systolic BP 112.2 ± 14.9 112.3 ± 12.0 0.976
Central diastolic BP 81.4 ± 12.9 83.5 ± 9.5 0.505
Central pulse pressure (mmHg) 32.0 ± 14.4 28.8 ± 6.9 0.301
Aortic augmentation pressure (mmHg) 4.4 ± 4.8 1.7 ± 5.8 0.078 Aortic augmentation index (%) 12.6 ± 12.1 2.4 ± 17.5 0.018
Aix@75 (%) 19.3 ± 11.9 9.4 ± 15.9 0.013
Pulse wave velocity (m/s) 9.3 ± 2.6 8.4 ± 2.5 0.228
Waveform analysis
Forward wave amplitude (mmHg) 25.5 ± 6.4 26.4 ± 4.8 0.549
Backward wave amplitude (mmHg) 15.8 ± 5.1 13.9 ± 6.1 0.226
Reflection magnitude (%) 64.5 ± 22.0 53.1 ± 22.1 0.065
Data are presented as mean ± SD or median [interquartile range (IQR)] or n (%).
eGFR, estimated glomerular filtration rate; NT-proBNP, N-terminal prohormone of brain natriuretic peptide; LVEDD, LV end-diastolic dimension; LVESV, LV end-systolic dimension; LV EF, LV ejection fraction; LAVI, left atrium volume index; PCWP, pulmonary capillary wedge pressure; BP, blood pressure; Aix@75, Aortic augmentation index (at heart rate 75 beats per minute).
Supplementary Table 3. Multivariate linear regression analysis to determine factors for peak VO2
according to Aix@75.
Variables Model 1
Coefficient Beta [95% CI]
p-
value Variables Model 2
Coefficient Beta [95% CI]
p-value
Recipient age -0.055 [-0.188 – 0.078] 0.405 Recipient age -0.100 [-0.214 – 0.013] 0.081 Hemoglobin 0.762 [-0.096 – 1.621] 0.080 Hemoglobin 0.744 [-0.084 – 1.571] 0.077 eGFR 0.023 [-0.093 – 0.140] 0.686 eGFR 0.018 [-0.092 – 0.128] 0.739 PCWP -0.291 [-0.592 – 0.010] 0.058 PCWP -0.213 [-0.503 – 0.077] 0.145 PWV -0.458 [-1.158 – 0.242] 0.194 RM -0.052 [-0.115 – 0.011] 0.106 Aix@75 -0.148 [-0.255 – -0.041] 0.008 Aix@75 -0.141 [-0.263 – -0.058] 0.003 eGFR, estimated glomerular filtration rate; PCWP, pulmonary capillary wedge pressure; PWV, pulse wave velocity; RM, reflection magnitude; Aix@75, aortic augmentation index (at heart rate 75 beats per minute);
Supplementary Table 4. Multivariate linear regression analysis to determine factors for peak VO2
according to Aix with heart rate adjustment.
Variables Model 1
Coefficient Beta [95% CI]
p-
value Model 2
Coefficient Beta [95% CI]
p- value Recipient age -0.031 [-0.169 – 0.107] 0.652 Recipient
age
-0.074 [-0.193 – 0.046] 0.220 Hemoglobin 0.845 [-0.029 – 1.719] 0.058 Hemoglobin 0.846 [0.001 – 1.691] 0.049 eGFR 0.056 [-0.067 – 0.178] 0.365 eGFR 0.040 [-0.073 – 0.152] 0.482 PCWP -0.310 [-0.617 – -0.002] 0.048 PCWP -0.241 [-0.538 – 0.056] 0.108
PWV -0.320 [-1.052 – 0.412] 0.382 RM -0.049 [-0.113 – 0.015] 0.130
Heart rate -0.193 [-0.382 – -0.004] 0.046 Heart rate -0.185 [-0.354 – -0.015] 0.034 Aix -0.145 [-0.256 – -0.033] 0.013 Aix -0.155 [-0.259 – -0.050] 0.005 eGFR, estimated glomerular filtration rate; PCWP, pulmonary capillary wedge pressure; PWV, pulse wave velocity; RM, reflection magnitude; Aix, aortic augmentation index.
Supplementary Figure legend
Supplementary Figure 1.Correlation plot between aortic stiffness parameters and recipient age.
Augmentation pressure, augmentation index (Aix), and Aix@75 were not significantly correlated with recipient age (A-C), but pulse wave velocity (PWV) was significantly correlated with recipient age (D) (R=0.57, p-value < 0.001).