The effects of bilateral lung transplantation on ventilatory efficiency, oxygen uptake and the right heart: A two-yr follow-up

Dirk Habedank, Ralf Ewert, Manfred Hummel, Michael Dandel, Friedrich Habedank, Christoph Knosalla, Hans B. Lehmkuhl, Stefan D. Anker, Roland Hetzer

Research output: Contribution to journalArticle

Abstract

Background: This study was to examine the course of ventilation/perfusion mismatch (VE/VCO2-slope) before and during two-yr follow-up after bilateral lung transplantation (BLTx) and to relate exercise parameters with the reverse right ventricular remodeling. Methods: We prospectively examined 20 patients (nine women; age 46.0±13.0yr) by cardiopulmonary exercise testing (before and at 3, 6, 12, and 24months after BLTx), and by echocardiography and blood gas analysis. Etiology of pulmonary failure was chronic obstructive pulmonary disease as well (n=8), pulmonary hypertension (n=7), idiopathic fibrosis (n=3), others (n=2). Results: The VE/VCO2-slope before BLTx was 47.5 (interquartile range 24.5) and declined at 3months -25.9%, 6months -30.9%, 12months -33.9%, and 24months -35.1% (all p≤0.003) and was then not different from normal. The right ventricular end diastolic diameter RVEDd narrowed from 35.0 (22.5) before to 31.0 (9.0) mm at 3months after LTx. Similarly, right ventricular systolic pressure (RVsys) decreased from 53.6±28.3 to 26.2±5.2mmHg (all p2-slope before (p2 increased from 10.0±2.3mL/min per kg before BLTx by 86.5% at 24months (p2-slope, peakVO2) improves quickly after lung transplantation and is accompanied by reverse remodeling of the right heart. A correlation between exercise parameters and right heart function was found before BLTx only.

Original languageEnglish
JournalClinical Transplantation
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 2011

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Keywords

  • Echocardiography
  • Exercise
  • Lung transplantation
  • Right heart
  • Ventilatory efficiency

ASJC Scopus subject areas

  • Transplantation

Cite this

Habedank, D., Ewert, R., Hummel, M., Dandel, M., Habedank, F., Knosalla, C., Lehmkuhl, H. B., Anker, S. D., & Hetzer, R. (2011). The effects of bilateral lung transplantation on ventilatory efficiency, oxygen uptake and the right heart: A two-yr follow-up. Clinical Transplantation, 25(1). https://doi.org/10.1111/j.1399-0012.2010.01318.x