Skip to main content
Erschienen in: Journal of Artificial Organs 4/2016

19.05.2016 | Original Article

Reversible decline in pulmonary function during left ventricular assist device therapy

verfasst von: Teruhiko Imamura, Koichiro Kinugawa, Osamu Kinoshita, Kan Nawata, Minoru Ono

Erschienen in: Journal of Artificial Organs | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
2.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
3.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
4.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
5.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
6.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
7.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
8.
Zurück zum Zitat 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
10.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
11.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
12.
Zurück zum Zitat 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.PubMed 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.PubMed
13.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
14.
Zurück zum Zitat Mohamedali B, Bhat G, Yost G, Tatooles A. Changes in spirometry after left ventricular assist device implantation. Artif Organs. 2015;39:1046–50.CrossRefPubMed Mohamedali B, Bhat G, Yost G, Tatooles A. Changes in spirometry after left ventricular assist device implantation. Artif Organs. 2015;39:1046–50.CrossRefPubMed
15.
Zurück zum Zitat Arena R, Humphrey R, McCall R. Altered exercise pulmonary function after left ventricular assist device implantation. J Cardiopulm Rehabil. 1999;19:344–6.CrossRefPubMed Arena R, Humphrey R, McCall R. Altered exercise pulmonary function after left ventricular assist device implantation. J Cardiopulm Rehabil. 1999;19:344–6.CrossRefPubMed
16.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
17.
Zurück zum Zitat 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.PubMed 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.PubMed
18.
Zurück zum Zitat 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. 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.
Metadaten
Titel
Reversible decline in pulmonary function during left ventricular assist device therapy
verfasst von
Teruhiko Imamura
Koichiro Kinugawa
Osamu Kinoshita
Kan Nawata
Minoru Ono
Publikationsdatum
19.05.2016
Verlag
Springer Japan
Erschienen in
Journal of Artificial Organs / Ausgabe 4/2016
Print ISSN: 1434-7229
Elektronische ISSN: 1619-0904
DOI
https://doi.org/10.1007/s10047-016-0907-8

Weitere Artikel der Ausgabe 4/2016

Journal of Artificial Organs 4/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.