Background: The present study investigated the predictors of adverse
outcomes in young adult patients with dilated cardiomyopathy (DCM) who underwent
heart transplantation (HTx). Methods: Twenty-four young adult
patients (aged 18–45 years) with DCM who underwent HTx in our hospital from
January 2012 to December 2022 were included in this retrospective analysis. Pre-
and post-HTx data were collected for echocardiography, N-terminal pro-brain
natriuretic peptide (NT-proBNP), and uric acid (UA). Data collected at the time
of DCM diagnosis were designated as baseline data. Post-HTx assessments were
conducted at 1 week and 3, 6, 12, and 36 months post-HTx. The primary endpoint
was defined as any adverse event, including left ventricular ejection fraction
(LVEF) 50% (n = 3), 50% increase in right or left ventricular diameter (n =
12), or death (n = 2). Patients were categorized into a non-adverse-event group
(n = 12) or an adverse-event group (n = 12). Results: Baseline NT-proBNP
(p = 0.014) and UA (p = 0.012) were significantly higher in the
adverse-event group than in the non-adverse-event group. Baseline NT-proBNP
7390 pg/mL (relative risk (RR) = 7.412, p = 0.046), UA 542
µmol/L (RR = 8.838, 95% confidence interval (95% CI) =
1.541–50.694, p = 0.014), and sustained reduction in LVEF (3%)
over a 2-year pharmacological treatment prior to HTx (RR = 3.252, p =
0.046) were significantly associated with an increased risk of adverse events
post-HTx. Conclusions: In young adult DCM patients post-HTx, heightened
baseline levels of NT-proBNP and UA levels and a sustained reduction in LVEF over
time prior to undergoing an HTx are significantly associated with an increased
risk of adverse events post-HTx. Future studies are needed to observe whether
individualized monitoring strategies could reduce the incidence of adverse events
following HTx in these patients.