P957Right ventricular dysfunction recovers after lung transplantation in pulmonary hypertension.


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Abstract

Objectives: This study sought to determine the effects of lung transplantation (LTx) on right ventricular (RV) morphology and function in patients with pulmonary hypertension (PH).Methods: 17 of 32 lung transplant recipients performed in 2009 in our center were identified as manifesting significant pulmonary hypertension (defined as pulmonary artery systolic pressure-PASP≥ 50 mmHg) before lung transplantation. Mean age was 54±7 years, and 53 % were men. Most common aetiologies were chronic obstructive pulmonary disease (47%) and pulmonary fibrosis (35 %). PASP before transplantation was 70±21 mmHg. Echocardiographic variables were evaluated before and 3 months after LTx. We analyzed RV functional (Tei index, tricuspid annular systolic excursion-TAPSE) and remodelling parameters (RV diastolic diameter, RV outflow tract-RVOT-diameter and systolic and diastolic eccentricity indexes), as well as right atrium (RA) volume.Results: Right ventricular functional and remodelling parameters markedly improved after lung transplantation. RV and RVOT diastolic diameter decreased (39±6 vs. 30±2,3 mm y 34±4 vs. 28±1,5 mm respectively; both p<0,05). RA volume decreased from 62±36 to 34±14 ml; p=0,008. Diastolic and systolic excentricity indexes were also reduced after LTx (1,35±0,3 vs.1,06±0,2 y 1,6±0,4 vs.1,05±0,24 respectively; p <0,05). Tei index improved (0,55±0,16 vs. 0,28±0,08; p=0,012). We also found a significant increased in TAPSE (17±2,2 vs. 21±3,4 mm; p=0,012).Conclusion: Right ventricular function and remodelling recovers early after lung transplantation, even in patients with severe preoperative RV dysfunction.

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