title: Changes in Spirometry After Left Ventricular Assist Device Implantation.
abstract: 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.
authors.affiliation: Department of Cardiology, Rush University, Chicago, IL, USA.
authors.forename: Burhan
authors.initials: B
authors.lastname: Mohamedali
authors.affiliation: Division of Cardiology and Cardiothoracic Surgery, Advocate Christ Medical Center, Chicago, IL, USA.
authors.forename: Geetha
authors.initials: G
authors.lastname: Bhat
authors.affiliation: Division of Cardiology and Cardiothoracic Surgery, Advocate Christ Medical Center, Chicago, IL, USA.
authors.forename: Gardner
authors.initials: G
authors.lastname: Yost
authors.affiliation: Division of Cardiology and Cardiothoracic Surgery, Advocate Christ Medical Center, Chicago, IL, USA.
authors.forename: Antone
authors.initials: A
authors.lastname: Tatooles
mesh_terms: D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011652:Pulmonary Circulation; D011653:Pulmonary Diffusing Capacity; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013147:Spirometry; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*; D014797:Vital Capacity
keywords: Diffusing capacity of the lungs for carbon monoxide; Left ventricular assist device; Mechanical assist device; Pulmonary function tests; Spirometry; Thoracic surgery; Ventricular assist device