Reversible decline in pulmonary function during left ventricular assist device therapy

J Artif Organs. 2016 Dec;19(4):330-335. doi: 10.1007/s10047-016-0907-8. Epub 2016 May 19.

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.

Keywords: Heart failure; Heart transplantation; Tidal volume.

MeSH terms

  • Adult
  • Echocardiography
  • Female
  • Heart Failure / diagnostic imaging
  • Heart Failure / physiopathology*
  • Heart Failure / surgery
  • Heart Transplantation*
  • Heart-Assist Devices*
  • Hemodynamics
  • Humans
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Respiratory Function Tests
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome