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.
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Mohamedali B, Bhat G, Yost G, Tatooles A. Changes in spirometry after left ventricular assist device implantation. Artif Organs. 2015;39:1046–50.
Arena R, Humphrey R, McCall R. Altered exercise pulmonary function after left ventricular assist device implantation. J Cardiopulm Rehabil. 1999;19:344–6.
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.
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.
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.
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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
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DOI: https://doi.org/10.1007/s10047-016-0907-8