TY - JOUR
T1 - Right ventricular recovery after bilateral lung transplantation for pulmonary arterial hypertension
AU - Gorter, Thomas M.
AU - Verschuuren, Erik A.M.
AU - Van Veldhuisen, Dirk J.
AU - Hoendermis, Elke S.
AU - Erasmus, Michiel E.
AU - Bogaard, Harm J.
AU - Vonk Noordegraaf, Anton
AU - Berger, Rolf M.F.
AU - Van Melle, Joost P.
AU - Willems, Tineke P.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - OBJECTIVES: Pulmonary arterial hypertension (PAH) is a progressive and often fatal disease characterized by increased pulmonary vascular resistance (PVR) and right ventricular (RV) failure. End-stage PAH is often an indication for a lung transplant (LTX). Our goal was to study ventricular recovery using cardiac magnetic resonance imaging late after LTX. METHODS: We studied 10 patients with PAH who underwent isolated bilateral LTX. RV and left ventricular (LV) volumes, function and mass were measured. In addition, the RV stroke volume/end-systolic ratio (SV/ESV), the LV eccentricity index, the RV/LV volume ratio, the area of the tricuspid valve annulus and the severity of tricuspid regurgitation (TR) were calculated. RESULTS: The median age was 44 [30-54] years and the mean PVR was 1020 ± 435 dynes·s·cm â ' 5. Six patients had ≥ moderate TR. After LTX, the RV ejection fraction increased from 32 to 64% (P < 0.001) and both RV volume (from 118 to 51 ml/m 2, P < 0.001) and RV mass (from 69 to 33 g/m 2, P < 0.001) decreased. The mean SV/ESV ratio increased from 0.5 to 1.9 (P < 0.001) and the LV mass increased from 55 to 61 g/m 2 (P = 0.005). There was a decrease in both the LV eccentricity index (from 2.8 to 1.1, P < 0.001) and the RV/LV volume ratio (from 2.3 to 0.8, P < 0.001). The area of the tricuspid valve annulus also decreased (from 9.8 to 4.6 cm 2 /m 2, P < 0.001); no patient had ≥ mild TR post-LTX. CONCLUSIONS: Cardiac magnetic resonance imaging confirms ventricular recovery after isolated bilateral LTX for end-stage PAH.
AB - OBJECTIVES: Pulmonary arterial hypertension (PAH) is a progressive and often fatal disease characterized by increased pulmonary vascular resistance (PVR) and right ventricular (RV) failure. End-stage PAH is often an indication for a lung transplant (LTX). Our goal was to study ventricular recovery using cardiac magnetic resonance imaging late after LTX. METHODS: We studied 10 patients with PAH who underwent isolated bilateral LTX. RV and left ventricular (LV) volumes, function and mass were measured. In addition, the RV stroke volume/end-systolic ratio (SV/ESV), the LV eccentricity index, the RV/LV volume ratio, the area of the tricuspid valve annulus and the severity of tricuspid regurgitation (TR) were calculated. RESULTS: The median age was 44 [30-54] years and the mean PVR was 1020 ± 435 dynes·s·cm â ' 5. Six patients had ≥ moderate TR. After LTX, the RV ejection fraction increased from 32 to 64% (P < 0.001) and both RV volume (from 118 to 51 ml/m 2, P < 0.001) and RV mass (from 69 to 33 g/m 2, P < 0.001) decreased. The mean SV/ESV ratio increased from 0.5 to 1.9 (P < 0.001) and the LV mass increased from 55 to 61 g/m 2 (P = 0.005). There was a decrease in both the LV eccentricity index (from 2.8 to 1.1, P < 0.001) and the RV/LV volume ratio (from 2.3 to 0.8, P < 0.001). The area of the tricuspid valve annulus also decreased (from 9.8 to 4.6 cm 2 /m 2, P < 0.001); no patient had ≥ mild TR post-LTX. CONCLUSIONS: Cardiac magnetic resonance imaging confirms ventricular recovery after isolated bilateral LTX for end-stage PAH.
KW - Cardiac magnetic resonance imaging
KW - Lung transplantation
KW - Pulmonary arterial hypertension
KW - Right ventricular failure
UR - http://www.scopus.com/inward/record.url?scp=85021109487&partnerID=8YFLogxK
U2 - 10.1093/icvts/ivx025
DO - 10.1093/icvts/ivx025
M3 - Article
C2 - 28329267
AN - SCOPUS:85021109487
SN - 1569-9293
VL - 24
SP - 890
EP - 897
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
IS - 6
ER -