Persistent abnormalities in pulmonary arterial compliance after heart transplantation in patients with combined post-capillary and pre-capillary pulmonary hypertension

The hemodynamic definitions of pulmonary hypertension (PH) in left heart disease have recently been refined to better match the characteristics required to reflect the presence of pulmonary vascular disease. Accordingly, we tested the hypothesis that abnormalities in the stiffness of pulmonary circu...

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Bibliographic Details
Published in:PloS one 2017-11, Vol.12 (11), p.e0188383-e0188383
Main Authors: Ghio, Stefano, Crimi, Gabriele, Pica, Silvia, Temporelli, Pier Luigi, Boffini, Massimo, Rinaldi, Mauro, Raineri, Claudia, Scelsi, Laura, Pistono, Massimo, Totaro, Rossana, Guida, Stefania, Oltrona Visconti, Luigi
Format: Article
Language:English
Subjects:
Abnormalities
Biology and Life Sciences
Capillary pressure
Cardiology
Cardiomyopathy
Cardiovascular disease
Care and treatment
Circulatory system
Complications and side effects
Coronary artery disease
Heart
Heart diseases
Heart failure
Heart surgery
Heart transplantation
Hemodynamics
Hypertension
Intubation
Lung diseases
Medical prognosis
Medicine and Health Sciences
Patient compliance
Patient outcomes
Patients
Physiological aspects
Pulmonary arteries
Pulmonary artery
Pulmonary circulation
Pulmonary hypertension
Risk factors
Stiffness
Transplantation
Transplants & implants
Vascular diseases
Veins & arteries
Ventricle
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Summary:The hemodynamic definitions of pulmonary hypertension (PH) in left heart disease have recently been refined to better match the characteristics required to reflect the presence of pulmonary vascular disease. Accordingly, we tested the hypothesis that abnormalities in the stiffness of pulmonary circulation would persist after heart transplantation in patients with combined post-capillary and pre-capillary PH (Cpc-PH) in contrast to those with isolated post-capillary PH (Ipc-PH). We retrospectively analyzed right heart hemodynamics in a cohort of 295 consecutive patients with heart failure and advanced left ventricular systolic dysfunction (LVSD) before and 1 year after heart transplantation. According to their baseline hemodynamic profile, patients were classified as: 75 Cpc-PH, 111 Ipc-PH, and 98 without PH (no-PH), and 11 pre-capillary PH. One year after heart transplantation, pulmonary artery pressures, pulmonary vascular resistance and cardiac index normalized in all patients regardless of the baseline hemodynamic profile. However, pulmonary arterial compliance remained lower in Cpc-PH patients (from 1.6±1.2 at baseline to 3.7±1.4 ml/mmHg at 1 year) than in Ipc-PH (from 1.2±2.0 to 4.4±2.3 ml/mmHg) and no-PH patients (from 3.7±2.0 to 4.5±1.8 ml/mmHg); (adjusted p = 0.03 Ipc-PH vs. Cpc-PH INT
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0188383