%0 Journal Article
%T Preoperative Cardiac Variables of Diastolic Dysfunction and Clinical Outcomes in Lung Transplant Recipients
%A Ajay Yadlapati
%A Joseph P. Lynch III
%A Rajan Saggar
%A David Ross
%A John A. Belperio
%A Stephen Weigt
%A Abbas Ardehali
%A Tristan Grogan
%A Eric H. Yang
%A Jamil Aboulhosn
%J Journal of Transplantation
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/391620
%X Background. Orthotopic lung transplantation is now widely performed in patients with advanced lung disease. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation; however, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function and elevated pretransplant pulmonary pressures. Methods. We reviewed the characteristics of 111 patients who underwent bilateral and unilateral lung transplants from 200 to 2009 in order to evaluate the prognostic significance of preoperative markers of diastolic function, including invasively measured pulmonary capillary wedge pressure (PCWP) and echocardiographic variables of diastolic dysfunction including mitral and . Results. Out of 111 patients, 62 were male (56%) and average age was 54.0 ¡À 10.5 years. Traditional echocardiographic Doppler variables of abnormal diastolic function, including and , did not predict adverse events ( ). Mildly elevated pretransplant PCWP (16¨C20£¿mmHg) and moderately/severely elevated PCWP (>20£¿mmHg) were not associated with adverse clinical events after transplant ( ). Additionally, all clinical endpoints did not show any statistical significance between the two groups. Conclusions. Pre-lung transplant invasive and echocardiographic findings of elevated pulmonary pressures and abnormal left ventricular diastolic function are not predictive of adverse posttransplant clinical events. 1. Introduction Nearly three decades have passed since the first successful clinical lung transplant was performed and has become the preferred treatment option for a variety of end-stage pulmonary parenchymal or pulmonary vascular disorders. Due to the shortage of available organs as well as the advancement of disease in most transplant candidates, a full array of preoperative tests is needed in order to consider these patients appropriate applicants. As part of the preoperative workup of these patients, investigation of cardiac function with echocardiography and catheterization has been long considered the norm, yet predictors of outcome from these tests are not well defined. The risk posed by cardiac dysfunction must be assessed individually based on severity of disease, presence of end-organ damage, and ease of control with standard therapies [1]. Patients with moderate or severe ventricular systolic dysfunction are typically excluded from lung transplantation; however, there is a paucity of data regarding the prognostic significance of abnormal left ventricular diastolic function or elevated
%U http://www.hindawi.com/journals/jtrans/2013/391620/