Pulmonary Function Testing and Outcomes in Subjects With Heart Failure Listed for Heart Transplantation.

BACKGROUND: Impaired spirometric parameters have been reported in patients with stage C heart failure and portend worse outcomes in these patients. The impact of spirometric parameters on outcomes in patients with stage D heart failure listed for heart transplantation is unknown. METHODS: We collect...

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Publicado en:Respiratory Care Vol. 60; no. 5; pp. 731 - 740
Autores principales: Georgiopoulou, Vasiliki V, Deka, Anjan, Song Li, Niazi, Anum A, Farooq, Kanwal, Kalogeropoulos, Andreas P, Butler, Javed, Alexopoulos, Dimitrios
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. May2015
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Pulmonary Function Testing and Outcomes in Subjects With Heart Failure Listed for Heart Transplantation.
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          Georgiopoulou, Vasiliki V
          Deka, Anjan
          Song Li
          Niazi, Anum A
          Farooq, Kanwal
          Kalogeropoulos, Andreas P
          Butler, Javed
          Alexopoulos, Dimitrios
        affil: Emory Clinical Cardiovascular Research Institute, Emory University, Atlanta, Georgia; Department of Cardiology, University of Patras, Patras, Greece
      sug:
        subj:
          Spirometry
          Heart Failure Physiopathology
          Treatment Outcomes
          Heart Transplantation
          Vital Capacity
          Human
          Male
          Female
          Descriptive Statistics
          Data Analysis Software
          Confidence Intervals
          Odds Ratio
          Cox Proportional Hazards Model
          Adult
          Middle Age
          Aged
          Forced Expiratory Volume
          Hemodynamics
          Respiratory Function Tests
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: Impaired spirometric parameters have been reported in patients with stage C heart failure and portend worse outcomes in these patients. The impact of spirometric parameters on outcomes in patients with stage D heart failure listed for heart transplantation is unknown. METHODS: We collected data on consecutive subjects listed for heart transplantation and examined the association of FEV1, FVC, and FEV1/FVC with (1) death or left ventricular assist device implantation (primary end point) and (2) death, left ventricular assist device implantation, or urgent transplantation (secondary end point). In a secondary analysis, we examined the association of baseline spirometry with post-transplant outcomes. RESULTS: Among 187 subjects (53 ± 10 y old, 17.1% women, 69.5% white subjects, 28.9% black subjects), there were 19 deaths, 28 left ventricular assist device implantations, and 74 urgent transplantations (primary end point of 25.1%, secondary end point of 64.7%) after a median of 5.5 months (interquartile range of 2.3-15.2). For FEV1, the hazard ratios for the primary and secondary end points were 0.93 (95% CI 0.61-1.41, P = .72) and 0.94 (95% CI 0.72-1.21, P = .62) per L, respectively. The hazard ratios of FVC were 0.90 (95% CI 0.65-1.25, P = .52) and 0.92 (95% CI 0.76-1.13, P = .43) per L, respectively. Impairment patterns (obstructive, restrictive, mixed) were not associated with risk for events. There was no interaction of spirometric parameters with smoking or lung disease for outcomes. Baseline spirometry was not associated with perioperative 30-d mortality (1.4%) and 1-y post-transplant survival (97.1%). CONCLUSIONS: In contrast to stage C subjects with heart failure, spirometric parameters were not associated with outcomes in this homogeneous stage D heart failure population.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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