open access

Vol 89, No 2 (2021)
Research paper
Published online: 2021-04-30
Submitted: 2020-12-05
Accepted: 2021-02-12
Get Citation

Prognostic significance of lung diffusion capacity and spirometric parameters in relation to hemodynamic status in heart transplant candidates

Somaye Mohammadi, Mohammad Mostafa Ansari Ramandi, Ali Safaei, Mahsa Mirdamadi, Sepideh Taghavi, Ahmad Amin, Nasim Naderi
DOI: 10.5603/ARM.a2021.0034
·
Pubmed: 33966259
·
Adv Respir Med 2021;89(2):115-123.

open access

Vol 89, No 2 (2021)
ORIGINAL PAPERS
Published online: 2021-04-30
Submitted: 2020-12-05
Accepted: 2021-02-12

Abstract

Introduction: Investigations have described a correlation between the severity of heart failure and the severity of pulmonary function abnormalities. In this study, we investigated the association of resting spirometric parameters, lung diffusion for carbon monoxide (DLCO), and the transfer coefficient (KCO) with hemodynamic variables and outcomes in a cohort of heart transplant candidates. Material and methods: Between January 2018 and January 2020, a total of 100 patients with advanced heart failure who were scheduled for right heart catheterization (RHC) as a pre-transplant evaluation measure were enrolled. Spirometry and DLCO were performed in all patients within 24 hours of their RHC. All selected patients were followed for a median (IQR) time of 6 (2–12) months. The end points of interest were heart failure-related mortality and a combined event involving HF-related mortality, heart transplantation (HTX), and need for the placement of a left ventricular assist device (LVAD).
Results: Among 846 patients scheduled for RHC, a total of 100 patients (25% female) with a mean (SD) age of 38.5 (12.8) were enrolled. There was a significant correlation between FEV1/FVC and CVP (r = –0.22, p = 0.02), PCWP (r = –0.4, p < 0.001), mPAP (r = –0.45, p < 0.001), and PVR (r = –0.32, p = 0.001). The cardiac output correlated with DLCO (r = 0.3, p = 0.008). Spirometry parameters, DLCO parameters, and hemodynamic parameters did not correlate with the combined event. Among the several variables, only PVR had an independent association with the combined event.
Conclusion: Both mechanical and gas diffusion parameters of the lung were not associated with outcomes in the homogeneous group of heart transplant candidates.

Abstract

Introduction: Investigations have described a correlation between the severity of heart failure and the severity of pulmonary function abnormalities. In this study, we investigated the association of resting spirometric parameters, lung diffusion for carbon monoxide (DLCO), and the transfer coefficient (KCO) with hemodynamic variables and outcomes in a cohort of heart transplant candidates. Material and methods: Between January 2018 and January 2020, a total of 100 patients with advanced heart failure who were scheduled for right heart catheterization (RHC) as a pre-transplant evaluation measure were enrolled. Spirometry and DLCO were performed in all patients within 24 hours of their RHC. All selected patients were followed for a median (IQR) time of 6 (2–12) months. The end points of interest were heart failure-related mortality and a combined event involving HF-related mortality, heart transplantation (HTX), and need for the placement of a left ventricular assist device (LVAD).
Results: Among 846 patients scheduled for RHC, a total of 100 patients (25% female) with a mean (SD) age of 38.5 (12.8) were enrolled. There was a significant correlation between FEV1/FVC and CVP (r = –0.22, p = 0.02), PCWP (r = –0.4, p < 0.001), mPAP (r = –0.45, p < 0.001), and PVR (r = –0.32, p = 0.001). The cardiac output correlated with DLCO (r = 0.3, p = 0.008). Spirometry parameters, DLCO parameters, and hemodynamic parameters did not correlate with the combined event. Among the several variables, only PVR had an independent association with the combined event.
Conclusion: Both mechanical and gas diffusion parameters of the lung were not associated with outcomes in the homogeneous group of heart transplant candidates.

Get Citation

Keywords

heart failure; transplantation; spirometry; lung diffusion for carbon monoxide; hemodynamics

About this article
Title

Prognostic significance of lung diffusion capacity and spirometric parameters in relation to hemodynamic status in heart transplant candidates

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 2 (2021)

Article type

Research paper

Pages

115-123

Published online

2021-04-30

DOI

10.5603/ARM.a2021.0034

Pubmed

33966259

Bibliographic record

Adv Respir Med 2021;89(2):115-123.

Keywords

heart failure
transplantation
spirometry
lung diffusion for carbon monoxide
hemodynamics

Authors

Somaye Mohammadi
Mohammad Mostafa Ansari Ramandi
Ali Safaei
Mahsa Mirdamadi
Sepideh Taghavi
Ahmad Amin
Nasim Naderi

References (18)
  1. Mancini D, Lietz K. Selection of cardiac transplantation candidates in 2010. Circulation. 2010; 122(2): 173–183.
  2. Ponikowski P, Voors A, Anker S, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2016; 37(27): 2129–2200.
  3. Lizak MK, Zakliczyński M, Jarosz A, et al. The influence of chronic heart failure on pulmonary function tests in patients undergoing orthotopic heart transplantation. Transplant Proc. 2009; 41(8): 3194–3197.
  4. Hoeper MM, Meyer K, Rademacher J, et al. Diffusion capacity and mortality in patients with pulmonary hypertension due to heart failure with preserved ejection fraction. JACC Heart Fail. 2016; 4(6): 441–449.
  5. Agostoni P, Bussotti M, Cattadori G, et al. Gas diffusion and alveolar-capillary unit in chronic heart failure. Eur Heart J. 2006; 27(21): 2538–2543.
  6. Magnussen H, Canepa M, Zambito PE, et al. What can we learn from pulmonary function testing in heart failure? Eur J Heart Fail. 2017; 19(10): 1222–1229.
  7. Ingle L, Shelton RJ, Cleland JGF, et al. Poor relationship between exercise capacity and spirometric measurements in patients with more symptomatic heart failure. J Card Fail. 2005; 11(8): 619–623.
  8. Deis T, Balling L, Rossing K, et al. Lung diffusion capacity in advanced heart failure: relation to central haemodynamics and outcome. ESC Heart Fail. 2019; 6(2): 379–387.
  9. Guazzi M, Pontone G, Brambilla R, et al. Alveolar-capillary membrane gas conductance: a novel prognostic indicator in chronic heart failure. Eur Heart J. 2002; 23(6): 467–476.
  10. Hoeper MM, Meyer K, Rademacher J, et al. Diffusion capacity and mortality in patients with pulmonary hypertension due to heart failure with preserved ejection fraction. JACC Heart Fail. 2016; 4(6): 441–449.
  11. Georgiopoulou VV, Deka A, Li S, et al. Pulmonary function testing and outcomes in subjects with heart failure listed for heart transplantation. Respir Care. 2015; 60(5): 731–739.
  12. Mettauer B, Lampert E, Charloux A, et al. Lung membrane diffusing capacity, heart failure, and heart transplantation. The American Journal of Cardiology. 1999; 83(1): 62–67.
  13. Ravenscraft SA, Gross CR, Kubo SH, et al. Pulmonary function after successful heart transplantation. One year follow-up. Chest. 1993; 103(1): 54–58.
  14. Stevenson LW, Pagani FD, Young JB, et al. INTERMACS profiles of advanced heart failure: the current picture. J Heart Lung Transplant. 2009; 28(6): 535–541.
  15. Culver BH, Graham BL, Coates AL, et al. Recommendations for a standardized pulmonary function report. An official american thoracic society technical statement. Am J Respir Crit Care Med. 2017; 196(11): 1463–1472.
  16. Graham BL, Brusasco V, Burgos F, et al. Executive Summary: 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J. 2017; 49(1).
  17. Amra B, Asadi M, Salehi H, et al. Normative reference values for lung transfer factor in Isfahan, Iran. Respirology. 2006; 11(4): 477–481.
  18. Skoczyński S, Mizia-Stec K, Semik-Orzech A, et al. Lung-heart clinical crosstalk in the course of COPD exacerbation. Pneumonol Alergol Pol. 2015; 83(1): 30–38.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl