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Preoperative Cardiac Variables of Diastolic Dysfunction and Clinical Outcomes in Lung Transplant Recipients

DOI: 10.1155/2013/391620

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Abstract:

Background. Orthotopic lung transplantation is now widely performed in patients with advanced lung disease. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation; however, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function and elevated pretransplant pulmonary pressures. Methods. We reviewed the characteristics of 111 patients who underwent bilateral and unilateral lung transplants from 200 to 2009 in order to evaluate the prognostic significance of preoperative markers of diastolic function, including invasively measured pulmonary capillary wedge pressure (PCWP) and echocardiographic variables of diastolic dysfunction including mitral and . Results. Out of 111 patients, 62 were male (56%) and average age was 54.0 ± 10.5 years. Traditional echocardiographic Doppler variables of abnormal diastolic function, including and , did not predict adverse events ( ). Mildly elevated pretransplant PCWP (16–20?mmHg) and moderately/severely elevated PCWP (>20?mmHg) were not associated with adverse clinical events after transplant ( ). Additionally, all clinical endpoints did not show any statistical significance between the two groups. Conclusions. Pre-lung transplant invasive and echocardiographic findings of elevated pulmonary pressures and abnormal left ventricular diastolic function are not predictive of adverse posttransplant clinical events. 1. Introduction Nearly three decades have passed since the first successful clinical lung transplant was performed and has become the preferred treatment option for a variety of end-stage pulmonary parenchymal or pulmonary vascular disorders. Due to the shortage of available organs as well as the advancement of disease in most transplant candidates, a full array of preoperative tests is needed in order to consider these patients appropriate applicants. As part of the preoperative workup of these patients, investigation of cardiac function with echocardiography and catheterization has been long considered the norm, yet predictors of outcome from these tests are not well defined. The risk posed by cardiac dysfunction must be assessed individually based on severity of disease, presence of end-organ damage, and ease of control with standard therapies [1]. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation; however, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function or elevated

References

[1]  M. Kreider and R. M. Kotloff, “Selection of candidates for lung transplantation,” Proceedings of the American Thoracic Society, vol. 6, no. 1, pp. 20–27, 2009.
[2]  S. F. Nagueh, C. P. Appleton, T. C. Gillebert et al., “Recommendations for the evaluation of keft ventricular diastolic function by echocardiography,” Journal of the American Society of Echocardiography, vol. 22, no. 2, pp. 107–133, 2009.
[3]  R. Y. Mahida, S. Wiscombe, and A. J. Fisher, “Current status of lung transplantation,” Chronic Respiratory Disease, vol. 9, no. 2, pp. 131–145, 2012.
[4]  K. G. Reyes, D. P. Mason, L. Thuita et al., “Guidelines for donor lung selection: time for revision?” The Annals of Thoracic Surgery, vol. 89, no. 6, pp. 1756–1764, 2010.
[5]  M. J. Russo, R. R. Davies, K. N. Hong et al., “Who is the high-risk recipient? Predicting mortality after lung transplantation using pretransplant risk factors,” Journal of Thoracic and Cardiovascular Surgery, vol. 138, no. 5, pp. 1234–1238, 2009.
[6]  J. G. Allen, G. J. Arnaoutakis, E. S. Weiss, C. A. Merlo, J. V. Conte, and A. S. Shah, “The impact of recipient body mass index on survival after lung transplantation,” The Journal of Heart and Lung Transplantation, vol. 29, no. 9, pp. 1026–1033, 2010.
[7]  W. Sherman, D. G. Rabkin, D. Ross et al., “Lung transplantation and coronary artery disease,” The Annals of Thoracic Surgery, vol. 92, no. 1, pp. 303–308, 2011.
[8]  J. L. Hook and D. J. Lederer, “Selecting lung transplant candidates: where do current guidelines fall short?” Expert Review of Respiratory Medicine, vol. 6, no. 1, pp. 51–61, 2012.
[9]  W. P. Abhayaratna, T. H. Marwick, W. T. Smith, and N. G. Becker, “Characteristics of left ventricular diastolic dysfunction in the community: an echocardiographic survey,” Heart, vol. 92, no. 9, pp. 1259–1264, 2006.
[10]  M. M. Redfield, S. J. Jacobsen, J. C. Burnett Jr., D. W. Mahoney, K. R. Bailey, and R. J. Rodeheffer, “Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic,” Journal of the American Medical Association, vol. 289, no. 2, pp. 194–202, 2003.
[11]  T. S. Tsang, M. E. Barnes, B. J. Gersh, K. R. Bailey, and J. B. Seward, “Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden,” The American Journal of Cardiology, vol. 90, no. 12, pp. 1284–1289, 2002.
[12]  H. Dokainish, W. A. Zoghbi, N. M. Lakkis et al., “Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure,” Journal of the American College of Cardiology, vol. 45, no. 8, pp. 1223–1226, 2005.
[13]  M. Wang, G. Yip, C.-M. Yu et al., “Independent and incremental prognostic value of early mitral annulus velocity in patients with impaired left ventricular systolic function,” Journal of the American College of Cardiology, vol. 45, no. 2, pp. 272–277, 2005.
[14]  J. Rubinstein, A. Pelosi, A. Vedre, P. Kotaru, and G. S. Abela, “Hypercholesterolemia and myocardial function evaluated via tissue doppler imaging,” Cardiovascular Ultrasound, vol. 7, no. 1, article 56, 2009.
[15]  G. S. Hillis, J. E. M?ller, P. A. Pellikka et al., “Noninvasive estimation of left ventricular filling pressure by E/e′ is a powerful predictor of survival after acute myocardial infarction,” Journal of the American College of Cardiology, vol. 43, no. 3, pp. 360–367, 2004.
[16]  E. F. Philbin, T. A. Rocco Jr., N. W. Lindenmuth, K. Ulrich, and P. L. Jenkins, “Systolic versus diastolic heart failure in community practice: clinical features, outcomes, and the use of angiotensin-converting enzyme inhibitors,” The American Journal of Medicine, vol. 109, no. 8, pp. 605–613, 2000.
[17]  A. Hansen, M. Haass, C. Zugck et al., “Prognostic value of doppler echocardiographic mitral inflow patterns: implications for risk stratification in patients with chronic congestive heart failure,” Journal of the American College of Cardiology, vol. 37, no. 4, pp. 1049–1055, 2001.
[18]  F. Nijland, O. Kamp, A. J. Karreman, M. J. Van Eenige, and C. A. Visser, “Prognostic implications of restrictive left ventricular filling in acute myocardial infarction: a serial doppler echocardiographic study,” Journal of the American College of Cardiology, vol. 30, no. 7, pp. 1618–1624, 1997.
[19]  G. Cerisano, L. Bolognese, P. Buonamici et al., “Prognostic implications of restrictive left ventricular filling in reperfused anterior acute myocardial infarction,” Journal of the American College of Cardiology, vol. 37, no. 3, pp. 793–799, 2001.
[20]  G. P. Aurigemma, J. S. Gottdiener, L. Shemanski, J. Gardin, and D. Kitzman, “Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: the cardiovascular health study,” Journal of the American College of Cardiology, vol. 37, no. 4, pp. 1042–1048, 2001.
[21]  R. S. Vasan, E. J. Benjamin, and D. Levy, “Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective,” Journal of the American College of Cardiology, vol. 26, no. 7, pp. 1565–1574, 1995.
[22]  R. S. Vasan, M. G. Larson, D. Levy, M. Galderisi, P. A. Wolf, and E. J. Benjamin, “Doppler transmitral flow indexes and risk of atrial fibrillation (the framingham heart study),” The American Journal of Cardiology, vol. 91, no. 9, pp. 1079–1083, 2003.
[23]  J. N. Bella, V. Palmieri, M. J. Roman et al., “Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: the strong heart study,” Circulation, vol. 105, no. 16, pp. 1928–1933, 2002.
[24]  G. Schillaci, L. Pasqualini, P. Verdecchia et al., “Prognostic significance of left ventricular diastolic dysfunction in essential hypertension,” Journal of the American College of Cardiology, vol. 39, no. 12, pp. 2005–2011, 2002.
[25]  M. Galderisi, “Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects,” Cardiovascular Ultrasound, vol. 3, article 9, 2005.
[26]  W. C. Brogan III, L. D. Hillis, E. D. Flores, and R. A. Lange, “The natural history of isolated left ventricular diastolic dysfunction,” The American Journal of Medicine, vol. 92, no. 6, pp. 627–630, 1992.
[27]  P. L. Temporelli, F. Scapellato, E. Eleuteri, A. Imparato, and P. Giannuzzi, “Doppler echocardiography in advanced systolic heart failure: a noninvasive alternative to Swan-Ganz Catheter,” Circulation, vol. 3, no. 3, pp. 387–394, 2010.
[28]  S. M. Shapiro, R. J. Oudiz, T. Cao et al., “Primary pulmonary hypertension: improved long-term effects and survival with continuous intravenous epoprostenol infusion,” Journal of the American College of Cardiology, vol. 30, no. 2, pp. 343–349, 1997.
[29]  S. M. Arcasoy, J. D. Christie, V. A. Ferrari et al., “Echocardiographic assessment of pulmonary hypertension in patients with advanced lung disease,” American Journal of Respiratory and Critical Care Medicine, vol. 167, no. 5, pp. 735–740, 2003.
[30]  A. Homma, A. Anzueto, J. I. Peters et al., “Pulmonary artery systolic pressures estimated by echocardiogram vs cardiac catheterization in patients awaiting lung transplantation,” The Journal of Heart and Lung Transplantation, vol. 20, no. 8, pp. 833–839, 2001.
[31]  I. Ben-Dor, D. Shitrit, M. R. Kramer, Z. Iakobishvili, G. Sahar, and D. Hasdai, “Is routine coronary angiography and revascularization indicated among patients undergoing evaluation for lung transplantation?” Chest, vol. 128, no. 4, pp. 2557–2562, 2005.
[32]  C. K. Choong, B. F. Meyers, T. J. Guthrie, E. P. Trulock, G. A. Patterson, and N. Moazami, “Does the presence of preoperative mild or moderate coronary artery disease affect the outcomes of lung transplantation?” The Annals of Thoracic Surgery, vol. 82, no. 3, pp. 1038–1042, 2006.
[33]  J. L. Lordan and P. A. Corris, “Pulmonary arterial hypertension and lung transplantation,” Expert Review of Respiratory Medicine, vol. 5, no. 3, pp. 441–454, 2011.
[34]  K. Bando, R. J. Keenan, I. L. Paradis et al., “Impact of pulmonary hypertension on outcome after single-lung transplantation,” The Annals of Thoracic Surgery, vol. 58, no. 5, pp. 1336–1342, 1994.
[35]  A. Fang, S. Studer, S. M. Kawut et al., “Elevated pulmonary artery pressure is a risk factor for primary graft dysfunction following lung transplantation for idiopathic pulmonary fibrosis,” Chest, vol. 139, no. 4, pp. 782–787, 2011.
[36]  J. D. Christie, J. E. Bavaria, H. I. Palevsky et al., “Primary graft failure following lung transplantation,” Chest, vol. 114, no. 1, pp. 51–60, 1998.
[37]  J. D. Christie, R. M. Kotloff, A. Pochettino et al., “Clinical risk factors for primary graft failure following lung transplantation,” Chest, vol. 124, no. 4, pp. 1232–1241, 2003.
[38]  B. A. Whitson, D. S. Nath, A. C. Johnson et al., “Risk factors for primary graft dysfunction after lung transplantation,” The Journal of Thoracic and Cardiovascular Surgery, vol. 131, no. 1, pp. 73–80, 2006.
[39]  T. P. Whelan, J. M. Dunitz, R. F. Kelly et al., “Effect of preoperative pulmonary artery pressure on early survival after lung transplantation for idiopathic pulmonary fibrosis,” The Journal of Heart and Lung Transplantation, vol. 24, no. 9, pp. 1269–1274, 2005.
[40]  J. P. Lynch III, R. Saggar, S. S. Weigt, D. J. Ross, and J. A. Belperio, “Overview of lung transplantation and criteria for selection of candidates,” Seminars in Respiratory and Critical Care Medicine, vol. 27, no. 5, pp. 441–469, 2006.
[41]  M. Estenne and R. M. Kotloff, “Update in transplantation 2005,” American Journal of Respiratory and Critical Care Medicine, vol. 173, no. 6, pp. 593–598, 2006.
[42]  M. de Perrot, M. Liu, T. K. Waddell, and S. Keshavjee, “Ischemia-reperfusion-induced lung injury,” American Journal of Respiratory and Critical Care Medicine, vol. 167, no. 4, pp. 490–511, 2003.
[43]  A. J. Boujoukos, G. D. Martich, J. D. Vega, R. J. Keenan, and B. P. Griffith, “Reperfusion injury in single-lung transplant recipients with pulmonary hypertension and emphysema,” The Journal of Heart and Lung Transplantation, vol. 16, no. 4, pp. 439–448, 1997.

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