21 May 2009
The influence of chronic heart failure on pulmonary function tests in patients undergoing orthotopic heart transplantation
M Lizak, M Zakliczyński, A Jarosz, M ZembalaAnn Transplant 2009; 14(1): 66-67 :: ID: 880443
Abstract
Background: Chronic heart failure and airway's obstruction have overlapping syndromes. World criteria for diagnosing and grading of airway's obstruction are based on spirometry results, but may be inadequate when cardiac failure coexists. Cardiac component of pulmonary function tests' (PFT) results can be measured in patients undergoing orthotopic heart transplantation (OHT).
Material/Methods: In 29 patients PFT were performed according to the Polish Phtisiopulmonology Society guidelines before and one year after OHT in the years 2006-2008. Willcoxon matched pairs' tests were used for analysis in Statistica 7.1. General group characteristics included age, sex, NYHA, CCS, BMI, present medication, blood tests and chemistry, exercise test, right heart catheterisation and echocardiography results.
Results: One year after OHT significant improvement in forced expiratory volume in the first second (FEV1) and its percent of predicted value (FEV1%), forced vital capacity (FVC), FVC%, vital capacity (VC) and VC% was observed (accordingly: 2.56 vs. 2.96l, 82 vs. 93%, 3.30 vs. 3.81l, 85 vs. 97%, 3.38 vs. 4.04l, 85 vs. 100%, p<0.01). FEV1 and FVC increment exceeded the cut-off point of 12% of normal value (accordingly: 0.38 and 0.47l) established as spirometry criterion for obstruction reversibility. Elimination of the heart failure by OHT did not result in signifi cant changes in FEV1 to FVC ratio (FEV1%FVC) used as main diagnostic criterion of chronic obstructive lung disease.
Conclusions: Chronic heart failure contributes to FEV1 variability of 0.4l or 12.6% of normal value which limits the usefulness of PFT in diagnosing and grading of airway obstruction in this group. Induction of inhaled betamimetics and steroids should be carefully considered and symptom-based in this group of patients since optimalisation of CHF treatment can be the best way to improve spirometry results. FEV1%FVC seems independent of concomitant heart function impairment.
Keywords: Heart Transplantation, clinical outcome
In Press
Case report
Pulmonary Embolism Following Living Donor Hepatectomy: A Report of 4 Cases and Literature ReviewAnn Transplant In Press; DOI: 10.12659/AOT.946752
Most Viewed Current Articles
03 Jan 2023 : Original article 6,527
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,222
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,152
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
17 Jan 2023 : Original article 5,279
Non-Cryopreserved Peripheral Blood Stem Cell Graft for Autologous Hematopoietic Stem Cell Transplantation i...DOI :10.12659/AOT.938595
Ann Transplant 2023; 28:e938595