Potential organ donors often exhibit abnormalities on electrocardiograms (ECGs) after brain death, but the physiological and prognostic significance of such abnormalities is unknown. This study sought to characterize the prevalence of ECG abnormalities in a nationwide cohort of potential cardiac donors and their associations with cardiac dysfunction, use for heart transplantation (HT), and recipient outcomes. The Donor Heart Study enrolled 4,333 potential cardiac organ donors at 8 organ procurement organizations across the United States from 2015 to 2020. A blinded expert reviewer interpreted all ECGs, which were obtained once hemodynamic stability was achieved after brain death and were repeated 24 ± 6 hours later. ECG findings were summarized, and their associations with other cardiac diagnostic findings, use for HT, and graft survival were assessed using univariable and multivariable regression. Initial ECGs were interpretable for 4,136 potential donors. Overall, 64% of ECGs were deemed clinically abnormal, most commonly as a result of a nonspecific St-T-wave abnormality (39%), T-wave inversion (19%), and/or QTc interval >500 ms (17%). Conduction abnormalities, ectopy, pathologic Q waves, and ST-segment elevations were less common (each present in ≤5% of donors) and resolved on repeat ECGs in most cases. Only pathological Q waves were significant predictors of donor heart nonuse (adjusted OR: 0.39; 95% CI: 0.29-0.53), and none were associated with graft survival at 1 year post-HT. ECG abnormalities are common in potential heart donors but often resolve on serial testing. Pathologic Q waves are associated with a lower likelihood of use for HT, but they do not portend worse graft survival.

中文翻译：

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供体心电图与心脏功能障碍、心脏移植使用和生存的关联：供体心脏研究

潜在的器官捐献者在脑死亡后经常表现出心电图（ECG）异常，但此类异常的生理和预后意义尚不清楚。本研究旨在描述全国潜在心脏捐赠者队列中心电图异常的患病率及其与心功能不全、心脏移植（HT）使用和受者结局的关系。供体心脏研究从 2015 年至 2020 年在美国 8 个器官采购组织招募了 4,333 名潜在心脏器官捐献者。一位盲法专家评审员解读了所有心电图，这些心电图是在脑死亡后实现血流动力学稳定后获得的，并在 24 ± 6 小时内重复之后。总结了心电图结果，并使用单变量和多变量回归评估了它们与其他心脏诊断结果、HT 使用和移植物存活的关联。 4,136 名潜在捐赠者的初始心电图是可以解释的。总体而言，64% 的心电图被认为临床异常，最常见的原因是非特异性 St-T 波异常 (39%)、T 波倒置 (19%) 和/或 QTc 间期 >500 ms (17%) ）。传导异常、异位、病理性 Q 波和 ST 段抬高不太常见（每种情况均在 ≤5% 的供者中出现），并且在大多数情况下通过重复心电图即可解决。只有病理性 Q 波是供体心脏不使用的显着预测因子（调整后 OR：0.39；95% CI：0.29-0.53），并且没有一个与 HT 后 1 年移植物存活相关。心电图异常在潜在的心脏捐赠者中很常见，但通常可以通过系列测试得到解决。病理性 Q 波与 HT 使用的可能性较低有关，但并不预示移植物存活率较差。