Carbon Monoxide Diffusing Capacity Predicts Cardiac Readmission in Patients Undergoing Left Ventricular Assist Device Implantation in Japan.
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
01 10 2021
01 10 2021
Historique:
pubmed:
21
1
2021
medline:
26
11
2021
entrez:
20
1
2021
Statut:
ppublish
Résumé
Carbon monoxide diffusion capacity (DLCO) is impaired in heart failure patients; however, its clinical impact has not been well investigated in the left ventricular assist device (LVAD) population. We explored the predictive value of preoperative DLCO in the survival and cardiac readmission rates after LVAD implantation. Seventy-six patients who received continuous-flow LVAD as bridge-to-transplant therapy from November 2007 to September 2018 and underwent pulmonary function test before LVAD implantation were included. The primary study endpoints were death and readmission for heart failure or arrhythmia (cardiac readmission). Patients were stratified into two groups according to the percent of predicted DLCO (%DLCO). Pulmonary vascular resistance (PVR) was equivocal between the groups preoperatively, whereas the low DLCO group (%DLCO < 80%) showed significantly high PVR postoperatively. The mortality rate was not different between the groups. The 2 year cardiac readmission rate was 33.5% in the low DLCO group and 8.7% in the high DLCO group (%DLCO ≥ 80%) (P = 0.028). The %DLCO was associated with cardiac readmission in univariate and multivariate analyses (hazard ratio: 4.32; 95% CI: 1.50-15.9; P = 0.005). Low %DLCO was associated with high PVR postoperatively and was a risk factor for cardiac readmission after LVAD implantation.
Identifiants
pubmed: 33470633
doi: 10.1097/MAT.0000000000001363
pii: 00002480-202110000-00006
doi:
Substances chimiques
Carbon Monoxide
7U1EE4V452
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1111-1118Informations de copyright
Copyright © ASAIO 2021.
Déclaration de conflit d'intérêts
Disclosure: E.A., M.H., and Y.H. belong to the Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, which is endowed by Actelion Pharmaceuticals Japan Ltd., Otsuka Pharmaceutical, NIPRO CORPORATION, Terumo Corp., Senko Medical Instrument Mfg., Century Medical Inc., Kinetic Concepts Inc., St. Jude Medical. The other authors have no conflicts of interest to report.
Références
Kiernan MS, Sundareswaran KS, Pham DT, et al.: Preoperative determinants of quality of life and functional capacity response to left ventricular assist device therapy. J Card Fail 2016.22: 797–805.
Rose EA, Gelijns AC, Moskowitz AJ, et al.Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group: Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med 2001.345: 1435–1443.
Slaughter MS, Pagani FD, Rogers JG, et al.: Clinical management of continuous-flow left ventricular assist devices in advanced heart failure. J Heart Lung Transplant 2010.29: S1–39.
Fukushima N, Ono M, Saiki Y, Sawa Y, Nunoda S, Isobe M: Registry report on heart transplantation in Japan (June 2016). Circ J 2017.81: 298–303.
Chua TP, Coats AJ: The lungs in chronic heart failure. Eur Heart J 1995.16: 882–887.
Kraemer MD, Kubo SH, Rector TS, Brunsvold N, Bank AJ: Pulmonary and peripheral vascular factors are important determinants of peak exercise oxygen uptake in patients with heart failure. J Am Coll Cardiol 1993.21: 641–648.
Sue DY, Oren A, Hansen JE, Wasserman K: Diffusing capacity for carbon monoxide as a predictor of gas exchange during exercise. N Engl J Med 1987.316: 1301–1306.
Deis T, Balling L, Rossing K, Wolsk E, Perch M, Gustafsson F: Lung diffusion capacity in advanced heart failure: Relation to central haemodynamics and outcome. ESC Heart Fail 2019.6: 379–387.
Nakamura K, Kanzaki H, Okada A, et al.: Independent prognostic value of pulmonary diffusing capacity in nonsmoking patients with chronic heart failure. Int Heart J 2019.60: 366–373.
Souza R, Fernandes CJ, Hoeper MM: Carbon monoxide diffusing capacity and the complexity of diagnosis in pulmonary arterial hypertension. Eur Respir J 2014.43: 963–965.
Sajgalik P, Kim CH, Stulak JM, et al.: Pulmonary function assessment post-left ventricular assist device implantation. ESC Heart Fail 2019.6: 53–61.
Daimee U, Kottmann M, Sherazi S, Alexis J, Chen L: Pre-operative pulmonary function tests and outcomes among patients receiving left ventricular assist devices. J Am Coll Cardiol 2016.67: 1376.
Raheja S, Nemeh H, Williams C, et al.: Pulmonary function testing and outcomes after left ventricular assist device implantation. Heart Surg Forum 2019.22: E202–E206.
Bedzra EKS, Dardas TF, Cheng RK, et al.: Pulmonary function tests do not predict mortality in patients undergoing continuous-flow left ventricular assist device implantation. J Thorac Cardiovasc Surg 2017.154: 1959–1970.e1951.
Miller MR, Hankinson J, Brusasco V, et al.ATS/ERS Task Force: Standardisation of spirometry. Eur Respir J 2005.26: 319–338.
Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ: Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3 rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013.143suppl 5e166S–e190S.
Brunelli A, Charloux A, Bolliger CT, et al.European Respiratory Society and European Society of Thoracic Surgeons joint task force on fitness for radical therapy: ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J 2009.34: 17–41.
Kormos RL, Teuteberg JJ, Pagani FD, et al.HeartMate II Clinical Investigators: Right ventricular failure in patients with the HeartMate II continuous-flow left ventricular assist device: Incidence, risk factors, and effect on outcomes. J Thorac Cardiovasc Surg 2010.139: 1316–1324.
Interagency Registry for Mechanically Assisted Circulatory Support. Appendix A - adverse event definitions. UAB School of MedicineAvailable at: https://www.uab.edu/medicine/intermacs/images/protocol-5-appendices/Appendix_A_INTERMACS_AE_Definitions_Final_02-4-2016.docx . Accessed July 20, 2020.
Torre-Amione G, Southard RE, Loebe MM, et al.: Reversal of secondary pulmonary hypertension by axial and pulsatile mechanical circulatory support. J Heart Lung Transplant 2010.29: 195–200.
Haft J, Armstrong W, Dyke DB, et al.: Hemodynamic and exercise performance with pulsatile and continuous-flow left ventricular assist devices. Circulation 2007.116suppl 11I8–15.
Guazzi M, Naeije R: Pulmonary hypertension in heart failure: Pathophysiology, pathobiology, and emerging clinical perspectives. J Am Coll Cardiol 2017.69: 1718–1734.
Asleh R, Hasin T, Briasoulis A, et al.: Hemodynamic assessment of patients with and without heart failure symptoms supported by a continuous-flow left ventricular assist device. Mayo Clin Proc 2018.93: 895–903.
Fayyaz AU, Edwards WD, Maleszewski JJ, et al.: Global pulmonary vascular remodeling in pulmonary hypertension associated with heart failure and preserved or reduced ejection fraction. Circulation 2018.137: 1796–1810.
Tedford RJ, Hemnes AR, Russell SD, et al.: PDE5A inhibitor treatment of persistent pulmonary hypertension after mechanical circulatory support. Circ Heart Fail 2008.1: 213–219.
Garan AR, Yuzefpolskaya M, Colombo PC, et al.: Ventricular arrhythmias and implantable cardioverter-defibrillator therapy in patients with continuous-flow left ventricular assist devices: Need for primary prevention? J Am Coll Cardiol 2013.61: 2542–2550.
Yoruk A, Sherazi S, Massey HT, et al.: Predictors and clinical relevance of ventricular tachyarrhythmias in ambulatory patients with a continuous flow left ventricular assist device. Heart Rhythm 2016.13: 1052–1056.
Raasch H, Jensen BC, Chang PP, et al.: Epidemiology, management, and outcomes of sustained ventricular arrhythmias after continuous-flow left ventricular assist device implantation. Am Heart J 2012.164: 373–378.
Benoist D, Stones R, Drinkhill M, Bernus O, White E: Arrhythmogenic substrate in hearts of rats with monocrotaline-induced pulmonary hypertension and right ventricular hypertrophy. Am J Physiol Heart Circ Physiol 2011.300: H2230–H2237.
Benoist D, Stones R, Drinkhill MJ, et al.: Cardiac arrhythmia mechanisms in rats with heart failure induced by pulmonary hypertension. Am J Physiol Heart Circ Physiol 2012.302: H2381–H2395.
Garan AR, Iyer V, Whang W, et al.: Catheter ablation for ventricular tachyarrhythmias in patients supported by continuous-flow left ventricular assist devices. ASAIO J 2014.60: 311–316.
Guazzi M, Pontone G, Brambilla R, Agostoni P, Rèina G: Alveolar–capillary membrane gas conductance: A novel prognostic indicator in chronic heart failure. Eur Heart J 2002.23: 467–476.
Hoeper MM, Meyer K, Rademacher J, Fuge J, Welte T, Olsson KM: Diffusion capacity and mortality in patients with pulmonary hypertension due to heart failure with preserved ejection fraction. JACC Heart Fail 2016.4: 441–449.
Cotes JE, Dabbs JM, Elwood PC, Hall AM, McDonald A, Saunders MJ: Iron-deficiency anaemia: Its effect on transfer factor for the lung (diffusiong capacity) and ventilation and cardiac frequency during sub-maximal exercise. Clin Sci 1972.42: 325–335.
Truby LK, Garan AR, Givens RC, et al.: Aortic insufficiency during contemporary left ventricular assist device support: Analysis of the INTERMACS registry. JACC Heart Fail 2018.6: 951–960.
Moss JD, Flatley EE, Beaser AD, et al.: Characterization of ventricular tachycardia after left ventricular assist device implantation as destination therapy: A single-center ablation experience. JACC Clin Electrophysiol 2017.3: 1412–1424.
American Thoracic Society: Single-breath carbon monoxide diffusing capacity (transfer factor). Recommendations for a standard technique--1995 update. Am J Respir Crit Care Med 1995.152: 2185–2198.
Wise RA, Teeter JG, Jensen RL, et al.: Standardization of the single-breath diffusing capacity in a multicenter clinical trial. Chest 2007.132: 1191–1197.