Mohamedali Burhan, Bhat Geetha, Yost Gardner, Tatooles Antone
Department of Cardiology, Rush University, Chicago, IL, USA.
Division of Cardiology and Cardiothoracic Surgery, Advocate Christ Medical Center, Chicago, IL, USA.
Artif Organs. 2015 Dec;39(12):1046-50. doi: 10.1111/aor.12507. Epub 2015 May 21.
Left ventricular assist devices (LVADs) are increasingly being used as life-saving therapy in patients with end-stage heart failure. The changes in spirometry following LVAD implantation and subsequent unloading of the left ventricle and pulmonary circulation are unknown. In this study, we explored long-term changes in spirometry after LVAD placement. In this retrospective study, we compared baseline preoperative pulmonary function test (PFT) results to post-LVAD spirometric measurements. Our results indicated that pulmonary function tests were significantly reduced after LVAD placement (forced expiratory volume in one second [FEV1 ]: 1.9 vs.1.7, P = 0.016; forced vital capacity [FVC]: 2.61 vs. 2.38, P = 0.03; diffusing capacity of the lungs for carbon monoxide [DLCO]: 14.75 vs. 11.01, P = 0.01). Subgroup analysis revealed greater impairment in lung function in patients receiving HeartMate II (Thoratec, Pleasanton, CA, USA) LVADs compared with those receiving HeartWare (HeartWare, Framingham, MA, USA) devices. These unexpected findings may result from restriction of left anterior hemi-diaphragm; however, further prospective studies to validate our findings are warranted.
左心室辅助装置（LVADs）越来越多地被用作终末期心力衰竭患者的救命疗法。LVAD植入后以及随后左心室和肺循环负荷减轻后肺活量测定的变化尚不清楚。在本研究中，我们探讨了LVAD植入后肺活量测定的长期变化。在这项回顾性研究中，我们将术前基线肺功能测试（PFT）结果与LVAD植入后的肺活量测定结果进行了比较。我们的结果表明，LVAD植入后肺功能测试显著降低（一秒用力呼气量[FEV1]：1.9对1.7，P = 0.016；用力肺活量[FVC]：2.61对2.38，P = 0.03；肺一氧化碳弥散量[DLCO]：14.75对11.01，P = 0.01）。亚组分析显示，与接受HeartWare（美国马萨诸塞州弗雷明汉市HeartWare公司）装置的患者相比，接受HeartMate II（美国加利福尼亚州普莱森顿市Thoratec公司）LVADs的患者肺功能损害更大。这些意外发现可能是由于左半侧膈肌受限所致；然而，需要进一步的前瞻性研究来验证我们的发现。
