Lung diffusion capacity correlates with pre‐implant pulmonary hypertension and predicts outcome after LVAD implantation

Aims Diffusing capacity of the lung for carbon monoxide (DLCO) reduction is common in heart failure (HF) and is associated with a worse prognosis. Correlations between DLCO and pulmonary hypertension (PH) are unclear, and published data are conflicting; it has been shown that DLCO impairment may per...

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Bibliographic Details
Published in:ESC Heart Failure 2023-04, Vol.10 (2), p.1043-1053
Main Authors: Macera, Francesca, Dewachter, Céline, Stefanidis, Constantin, Vanden Eynden, Frédéric, Bondue, Antoine, Vachiéry, Jean‐Luc, Roussoulières, Ana
Format: Article
Language:English
Subjects:
Advanced heart failure
Body mass index
Carbon monoxide
Cardiac catheterization
Cardiomyopathy
Cardiovascular disease
DLCO
Heart failure
Heart Failure - complications
Heart Failure - surgery
Hemodynamics
Humans
Hypertension, Pulmonary
Intubation
Lung
LVAD
Medical prognosis
Mortality
Original
Patients
Pulmonary arteries
Pulmonary circulation
Pulmonary hypertension
Retrospective Studies
Right heart catheterization
Statistical analysis
Transplants & implants
Variables
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Summary:Aims Diffusing capacity of the lung for carbon monoxide (DLCO) reduction is common in heart failure (HF) and is associated with a worse prognosis. Correlations between DLCO and pulmonary hypertension (PH) are unclear, and published data are conflicting; it has been shown that DLCO impairment may persist or even worsen after normalization of pulmonary pressures following left ventricle assist device (LVAD) implantation, maybe reflecting persistent pulmonary damage. We aimed to investigate the impact of pre‐implant DLCO and central haemodynamics on outcome in patients with advanced HF implanted with a LVAD. Methods and results We retrospectively analysed pre‐implant and post‐implant data from 42 patients implanted with a LVAD at our institution. Out of 42 patients, 35 had post‐capillary PH before implantation, including 17 with combined post‐ and pre‐capillary PH (Cpc‐PH). Median DLCO was 59% (IQR 47–68%), and it inversely correlated with pulmonary vascular resistance (PVR) (P 0.037) and diastolic pulmonary gradient (DPG) (P 0.042). Compared with baseline, LVAD resulted in improvement in LV diameter (LVDd, P 
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.14256