Pulmonary Capillary Recruitment Is Attenuated Post Left Ventricular Assist Device Implantation
Section snippets
Methods
The present single-center study was a within-subject design, comparing preassessment (before LVAD implantation) and 3 months after implantation. Initially, 20 patients with severe heart failure (HF) who were scheduled for CF-LVAD (HeartMate II or Heart Ware) implantation consented and volunteered to participate in the study; however, only 17 patients completed the 3-month assessment. Preassessment was performed within 7 days before CF-LVAD implantation, and postassessment was performed within
Results
Before CF-LVAD, subjects showed impaired (% predicted) measures of pulmonary function including a reduced FVC, FEV1, FEV1/FVC, and FEF25-75 (Table 2). At 3 months after CF-LVAD, FVC and FEV1 remained marginally reduced but were not different to pre–CF-LVAD baseline values (p = 0.10 and p = 0.37, respectively, Table 2). Furthermore, FEV1/FVC and FEF25-75 were not significantly changed at 3 months after implantation compared with before implantation (p = 0.23 and p = 0.80, respectively, Table 2).
Discussion
In this study, we investigated ways pulmonary function and measures of pulmonary physiology specific to pulmonary circulation were influenced by CF-LVAD implantation. At 3 months after CF-LVAD implantation, pulmonary function was not significantly altered from baseline. However, Vc and Dm were significantly reduced without an alteration in the Dm/Vc ratio, which indicates a reduction in alveolar-capillary recruitment. For lung diffusing capacity, DLCO and DLNO were significantly reduced. Even
Declaration of Competing Interest
The authors have no conflicts of interest to declare.
Availability of data and materials
The data generated and/or analyzed during the present study are not deposited but are available from the corresponding author upon reasonable request.
References (22)
- et al.
Results of the destination therapy post-food and drug administration approval study with a continuous flow left ventricular assist device: a prospective study using the INTERMACS registry (Interagency Registry for Mechanically Assisted Circulatory Support)
J Am Coll Cardiol
(2014) - et al.
Current status of left ventricular assist device therapy
Mayo Clin Proc
(2016) - et al.
Does the bronchial circulation contribute to congestion in heart failure?
Med Hypotheses
(2009) - et al.
Lung function and survival in patients with left ventricular assist devices
J Heart Lung Transplant
(2017) - et al.
Pulmonary function is associated with length of stay and survival in patients receiving permanent left ventricular assist devices
J Card Fail
(2014) - et al.
Improved left ventricular function after chronic left ventricular unloading
Ann Thorac Surg
(1996) - et al.
Cardiac recovery in dilated cardiomyopathy by unloading with a left ventricular assist device
Ann Thorac Surg
(1999) - et al.
Use of a continuous-flow device in patients awaiting heart transplantation
N Engl J Med
(2007) - et al.
A fully magnetically levitated left ventricular assist device – Final report
N Engl J Med
(2019) - et al.
The interactions between respiratory and cardiovascular systems in systolic heart failure
J Appl Physiol (1985)
(2020)
Changes in spirometry after left ventricular assist device implantation
Artif Organs
Cited by (1)
The Pulmonary System: A Different Sort of End Organ for Left Ventricular Assist Device Therapy
2023, American Journal of Cardiology
This study was supported by Mayo Clinic Department of Cardiovascular Diseases (Rochester, Minnesota) and Medtronic (Minneapolis, Minnesota).