Right but not left ventricular function recovers early after living-donor lobar lung transplantation in patients with pulmonary arterial hypertension

Shinichi Toyooka, Kengo Fukushima Kusano, Keiji Goto, Masaomi Yamane, Takahiro Oto, Yoshifumi Sano, Soichiro Fuke, Megumi Okazaki, Toru Ohe, Shingo Kasahara, Shunji Sano, Hiroshi Date

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Abstract

Objective: The aim of this study was to evaluate right and left ventricular functions in patients with pulmonary arterial hypertension after living-donor lobar lung transplantation compared with those without hypertension. Methods: Thirty-three recipients of living-donor lobar lung transplantation were divided into two groups: those with pulmonary arterial hypertension (PAH group; n = 12) and those without (non-PAH group; n = 21). Their systolic pulmonary artery pressure was 93.1 ± 6.7 mm Hg versus 31.4 ± 2.9 mm Hg, respectively. Right and left ventricular ejection fractions, systolic pulmonary artery pressure, and cardiac index were serially measured by radionuclide ventriculography and right heart catheterization, respectively. Results: Pretransplant right and left ventricular ejection fractions were lower in the PAH group (29.8% ± 7.0%, 49.9% ± 6.6%) than in the non-PAH group (49.7% ± 3.3%, 65.2% ± 1.9%) (P = .010, .068). Two months after living-donor lobar lung transplantation, right ventricular ejection fraction and systolic pulmonary artery pressure in the PAH group (57.3% ± 5.1%, 25.7 ± 1.8 mm Hg) improved dramatically, equal to those in the non-PAH group. In contrast, left ventricular ejection fraction and cardiac index in the PAH group (50.9% ± 3.7%, 2.66 ± 0.12 L · min-1 · m-2) were still significantly lower than in the non-PAH group (65.4% ± 2.8%, 3.13 ± 0.15 L · min-1 · m-2) (P = .0038, .037). At 6 to 12 months, the PAH group demonstrated a significant rise in left ventricular ejection fraction and cardiac index that reached similar values in the non-PAH group measured at 2 months. These values were stable for up to 3 years. Conclusions: Right ventricular function recovered early after living-donor lobar lung transplantation in the PAH group. In contrast, recovery of left ventricular function required 6 to 12 months. Improved cardiac function was sustained for up to 3 years, suggesting long-term durability of cardiac function recovery after living-donor lobar lung transplantation.

Original languageEnglish
Pages (from-to)222-226
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume138
Issue number1
DOIs
Publication statusPublished - Jul 2009

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Lung Transplantation
Living Donors
Left Ventricular Function
Pulmonary Hypertension
Stroke Volume
Pulmonary Artery
Right Ventricular Function
Pressure
Radionuclide Ventriculography
Recovery of Function
Cardiac Catheterization
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Right but not left ventricular function recovers early after living-donor lobar lung transplantation in patients with pulmonary arterial hypertension. / Toyooka, Shinichi; Kusano, Kengo Fukushima; Goto, Keiji; Yamane, Masaomi; Oto, Takahiro; Sano, Yoshifumi; Fuke, Soichiro; Okazaki, Megumi; Ohe, Toru; Kasahara, Shingo; Sano, Shunji; Date, Hiroshi.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 138, No. 1, 07.2009, p. 222-226.

Research output: Contribution to journalArticle

Toyooka, Shinichi ; Kusano, Kengo Fukushima ; Goto, Keiji ; Yamane, Masaomi ; Oto, Takahiro ; Sano, Yoshifumi ; Fuke, Soichiro ; Okazaki, Megumi ; Ohe, Toru ; Kasahara, Shingo ; Sano, Shunji ; Date, Hiroshi. / Right but not left ventricular function recovers early after living-donor lobar lung transplantation in patients with pulmonary arterial hypertension. In: Journal of Thoracic and Cardiovascular Surgery. 2009 ; Vol. 138, No. 1. pp. 222-226.
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author = "Shinichi Toyooka and Kusano, {Kengo Fukushima} and Keiji Goto and Masaomi Yamane and Takahiro Oto and Yoshifumi Sano and Soichiro Fuke and Megumi Okazaki and Toru Ohe and Shingo Kasahara and Shunji Sano and Hiroshi Date",
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T1 - Right but not left ventricular function recovers early after living-donor lobar lung transplantation in patients with pulmonary arterial hypertension

AU - Toyooka, Shinichi

AU - Kusano, Kengo Fukushima

AU - Goto, Keiji

AU - Yamane, Masaomi

AU - Oto, Takahiro

AU - Sano, Yoshifumi

AU - Fuke, Soichiro

AU - Okazaki, Megumi

AU - Ohe, Toru

AU - Kasahara, Shingo

AU - Sano, Shunji

AU - Date, Hiroshi

PY - 2009/7

Y1 - 2009/7

N2 - Objective: The aim of this study was to evaluate right and left ventricular functions in patients with pulmonary arterial hypertension after living-donor lobar lung transplantation compared with those without hypertension. Methods: Thirty-three recipients of living-donor lobar lung transplantation were divided into two groups: those with pulmonary arterial hypertension (PAH group; n = 12) and those without (non-PAH group; n = 21). Their systolic pulmonary artery pressure was 93.1 ± 6.7 mm Hg versus 31.4 ± 2.9 mm Hg, respectively. Right and left ventricular ejection fractions, systolic pulmonary artery pressure, and cardiac index were serially measured by radionuclide ventriculography and right heart catheterization, respectively. Results: Pretransplant right and left ventricular ejection fractions were lower in the PAH group (29.8% ± 7.0%, 49.9% ± 6.6%) than in the non-PAH group (49.7% ± 3.3%, 65.2% ± 1.9%) (P = .010, .068). Two months after living-donor lobar lung transplantation, right ventricular ejection fraction and systolic pulmonary artery pressure in the PAH group (57.3% ± 5.1%, 25.7 ± 1.8 mm Hg) improved dramatically, equal to those in the non-PAH group. In contrast, left ventricular ejection fraction and cardiac index in the PAH group (50.9% ± 3.7%, 2.66 ± 0.12 L · min-1 · m-2) were still significantly lower than in the non-PAH group (65.4% ± 2.8%, 3.13 ± 0.15 L · min-1 · m-2) (P = .0038, .037). At 6 to 12 months, the PAH group demonstrated a significant rise in left ventricular ejection fraction and cardiac index that reached similar values in the non-PAH group measured at 2 months. These values were stable for up to 3 years. Conclusions: Right ventricular function recovered early after living-donor lobar lung transplantation in the PAH group. In contrast, recovery of left ventricular function required 6 to 12 months. Improved cardiac function was sustained for up to 3 years, suggesting long-term durability of cardiac function recovery after living-donor lobar lung transplantation.

AB - Objective: The aim of this study was to evaluate right and left ventricular functions in patients with pulmonary arterial hypertension after living-donor lobar lung transplantation compared with those without hypertension. Methods: Thirty-three recipients of living-donor lobar lung transplantation were divided into two groups: those with pulmonary arterial hypertension (PAH group; n = 12) and those without (non-PAH group; n = 21). Their systolic pulmonary artery pressure was 93.1 ± 6.7 mm Hg versus 31.4 ± 2.9 mm Hg, respectively. Right and left ventricular ejection fractions, systolic pulmonary artery pressure, and cardiac index were serially measured by radionuclide ventriculography and right heart catheterization, respectively. Results: Pretransplant right and left ventricular ejection fractions were lower in the PAH group (29.8% ± 7.0%, 49.9% ± 6.6%) than in the non-PAH group (49.7% ± 3.3%, 65.2% ± 1.9%) (P = .010, .068). Two months after living-donor lobar lung transplantation, right ventricular ejection fraction and systolic pulmonary artery pressure in the PAH group (57.3% ± 5.1%, 25.7 ± 1.8 mm Hg) improved dramatically, equal to those in the non-PAH group. In contrast, left ventricular ejection fraction and cardiac index in the PAH group (50.9% ± 3.7%, 2.66 ± 0.12 L · min-1 · m-2) were still significantly lower than in the non-PAH group (65.4% ± 2.8%, 3.13 ± 0.15 L · min-1 · m-2) (P = .0038, .037). At 6 to 12 months, the PAH group demonstrated a significant rise in left ventricular ejection fraction and cardiac index that reached similar values in the non-PAH group measured at 2 months. These values were stable for up to 3 years. Conclusions: Right ventricular function recovered early after living-donor lobar lung transplantation in the PAH group. In contrast, recovery of left ventricular function required 6 to 12 months. Improved cardiac function was sustained for up to 3 years, suggesting long-term durability of cardiac function recovery after living-donor lobar lung transplantation.

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