Skip to main content
Log in

Reversible decline in pulmonary function during left ventricular assist device therapy

  • Original Article
  • Artificial Heart (Clinical)
  • Published:
Journal of Artificial Organs Aims and scope Submit manuscript

Abstract

Cardiac replacement therapy, consisting of left ventricular assist device (LVAD) implant surgery and heart transplantation, has considerably reduced the mortality and morbidity of patients with stage D heart failure. However, its impact on pulmonary function remains unclear. We retrospectively evaluated 22 consecutive patients (16 men; 42 ± 13 years old) who had undergone pulmonary function tests during the heart failure, LVAD, and heart transplantation periods. The LVAD therapy lasted an average of 871 ± 267 days. The % vital capacity and forced expiratory volume in 1 s decreased significantly after LVAD implantation and returned to baseline levels after heart transplantation. Correlation analysis indicated that a shorter duration of LVAD support was associated with a more significant improvement in % vital capacity in heart transplantation recipients, compared to the pre-LVAD period and the LVAD period. In conclusion, we provide evidence that a decrease in pulmonary function occurs during LVAD support but it may be reversible. Limited LVAD duration may be a key for the recovery of pulmonary dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kirklin JK, Naftel DC, Pagani FD, Kormos RL, Stevenson LW, Blume ED, et al. Seventh INTERMACS annual report: 15,000 patients and counting. J Heart Lung Transplant. 2015;34:1495–504.

    Article  PubMed  Google Scholar 

  2. Imamura T, Kinugawa K, Shiga T, Endo M, Kato N, Inaba T, et al. Preoperative levels of bilirubin or creatinine adjusted by age can predict their reversibility after implantation of left ventricular assist device. Circ J. 2013;77:96–104.

    Article  CAS  PubMed  Google Scholar 

  3. Imamura T, Kinugawa K, Hatano M, Kato N, Minatsuki S, Muraoka H, et al. Acute pulmonary vasoreactivity test with sildenafil or nitric monoxide before left ventricular assist device implantation. J Artif Organs. 2013;16:389–92.

    Article  CAS  PubMed  Google Scholar 

  4. Hosenpud JD, Stibolt TA, Atwal K, Shelley D. Abnormal pulmonary function specifically related to congestive heart failure: comparison of patients before and after cardiac transplantation. Am J Med. 1990;88:493–6.

    Article  CAS  PubMed  Google Scholar 

  5. Olson TP, Beck KC, Johnson JB, Johnson BD. Competition for intrathoracic space reduces lung capacity in patients with chronic heart failure: a radiographic study. Chest. 2006;130:164–71.

    Article  PubMed  Google Scholar 

  6. Agostoni P, Cattadori G, Guazzi M, Palermo P, Bussotti M, Marenzi G. Cardiomegaly as a possible cause of lung dysfunction in patients with heart failure. Am Heart J. 2000;140:e24.

    Article  CAS  PubMed  Google Scholar 

  7. Dimopoulou I, Daganou M, Tsintzas OK, Tzelepis GE. Effects of severity of long-standing congestive heart failure on pulmonary function. Respir Med. 1998;92:1321–5.

    Article  CAS  PubMed  Google Scholar 

  8. Miniati M, Monti S, Bottai M, Pavlickova I, Passino C, Emdin M, et al. Prognostic value of alveolar volume in systolic heart failure: a prospective observational study. BMC Pulm Med. 2013;13:69.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to update the 2001 guidelines for the evaluation and management of heart failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154–235.

    Article  PubMed  Google Scholar 

  10. Imamura T, Kinugawa K, Ono M, Kagami Y, Endo M, Minatsuki S, et al. Everolimus-incorporated immunosuppressant strategy improves renal dysfunction while maintaining low rejection rates after heart transplantation in Japanese patients. Int Heart J. 2013;54:222–7.

    Article  CAS  PubMed  Google Scholar 

  11. Agostoni PG, Guazzi M, Bussotti M, Grazi M, Palermo P, Marenzi G. Lack of improvement of lung diffusing capacity following fluid withdrawal by ultrafiltration in chronic heart failure. J Am Coll Cardiol. 2000;36:1600–4.

    Article  CAS  PubMed  Google Scholar 

  12. Mustafa KY, Nour MM, Shuhaiber H, Yousof AM. Pulmonary function before and sequentially after valve replacement surgery with correlation to preoperative hemodynamic data. Am Rev Respir Dis. 1984;130:400–6.

    CAS  PubMed  Google Scholar 

  13. Shenkman Z, Shir Y, Weiss YG, Bleiberg B, Gross D. The effects of cardiac surgery on early and late pulmonary functions. Acta Anaesthesiol Scand. 1997;41:1193–9.

    Article  CAS  PubMed  Google Scholar 

  14. Mohamedali B, Bhat G, Yost G, Tatooles A. Changes in spirometry after left ventricular assist device implantation. Artif Organs. 2015;39:1046–50.

    Article  CAS  PubMed  Google Scholar 

  15. Arena R, Humphrey R, McCall R. Altered exercise pulmonary function after left ventricular assist device implantation. J Cardiopulm Rehabil. 1999;19:344–6.

    Article  CAS  PubMed  Google Scholar 

  16. Nakatani T, Fukushima N, Ono M, Saiki Y, Matsuda H, Nunoda S, et al. The registry report of heart transplantation in Japan (1999–2014). Circ J. 2015;80:44–50.

    Article  PubMed  Google Scholar 

  17. Laoutaris ID, Dritsas A, Adamopoulos S, Manginas A, Gouziouta A, Kallistratos MS, et al. Benefits of physical training on exercise capacity, inspiratory muscle function, and quality of life in patients with ventricular assist devices long-term postimplantation. Eur J Cardiovasc Prev Rehabil. 2011;18:33–40.

    PubMed  Google Scholar 

  18. Laoutaris ID, Dritsas A, Brown MD, Manginas A, Kallistratos MS, Sfirakis P, et al. Inspiratory muscle training in a patient with left ventricular assist device. Hell J Cardiol. 2006;47:238–41.

    Google Scholar 

Download references

Acknowledgments

None.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Teruhiko Imamura or Koichiro Kinugawa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Imamura, T., Kinugawa, K., Kinoshita, O. et al. Reversible decline in pulmonary function during left ventricular assist device therapy. J Artif Organs 19, 330–335 (2016). https://doi.org/10.1007/s10047-016-0907-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-016-0907-8

Keywords

Navigation