Assessment of Left Ventricular Diastolic Function After Single Lung Transplantation in Patients With Severe Pulmonary Hypertension: Late Changes After Lung Transplantation
Late Changes After Lung Transplantation
One year later, the improvement in both right ventricular function and left ventricular geometry was sustained in all surviving patients. One patient died from respiratory failure 4 months after transplantation. A significant reduction in left ventricular relaxation time (from 127±14 to 91 ±8, p<0.05) was observed 1 year later after lung transplantation, which was associated with increases in left ventricular early filling, E from 32±6 to 70±12 cm/s (p<0.05) and Ei from 2.8±1.0 to 9.6±3.0 cm (p<0.05). No significant changes in atrial filling as measured by A or Ai were observed. Compared with Doppler measurements from the control group, all left ventricular diastolic variables but isovolumic relaxation time reached the normal range as defined by the control group.
It is important to restore right ventricular function after single lung transplantation in pulmonary hypertension patients. A number of studies have shown that the right ventricular function improves dramatically immediately after transplantation, and the improvement is maintained for at least 2 years read antibiotics online. Interestingly, our study indicated that the impaired left ventricular early filling persisted early after transplantation, despite the fact that pulmonary hypertension was alleviated and left ventricular geometry was restored. Our data also showed that the transmitral flow and isovolumic relaxation time might require up to 1 year to return to normal.
Louie et al studied left ventricular filling by Doppler echocardiography in nine patients with primary pulmonary hypertension. They found a decrease in early filling, an increase in atrial contribution to total filling and a prolongation in isovolumic relaxation time in these patients. They also observed that the ventricular septum was flattened toward the left ventricular cavity at end-systole and early diastole, while at end-diastole, the ventricular septal configuration returned to a more normal shape.