title: Reverse Right Ventricular Remodeling After Lung Transplantation in Patients With Pulmonary Arterial Hypertension Under Combination Therapy of Targeted Medical Drugs.
abstract: Patients with pulmonary arterial hypertension (PAH) are currently treated with combination therapy of PAH-targeted drugs. Reverse right ventricular (RV) remodeling after lung transplantation (LTx) in patients with end-stage PAH despite combination therapy of PAH-targeted drugs has not been fully elucidated.
  
  
  
  A total of 136 patients, including 32 with PAH, underwent LTx from 1998 to 2014. We enrolled 12 consecutive patients with PAH treated with combination therapy of PAH-targeted drugs who underwent LTx and retrospectively analyzed the temporal and serial changes in hemodynamics and echocardiography before LTx and at 3 and 12 months after LTx. Before LTx, the RV was markedly dilated with substantially reduced RV fractional area change (RVFAC). At 3 months after LTx, pulmonary artery pressure, pulmonary vascular resistance and RV stroke work index were significantly decreased, while left ventricular stroke work index was increased. RV size assessed by echocardiography also significantly decreased and RVFAC improved. At 12 months after LTx, RVFAC was further increased and RV wall thickness was decreased significantly.
  
  
  
  Although severe RV dysfunction and dilation were observed in patients with end-stage PAH despite combination therapy of PAH-targeted drugs, RV function and morphology were improved after reduction of RV pressure load by LTx.
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Sarashina
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Akagi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Oe
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ejiri
authors.forename: Koji
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nishii
authors.forename: Hiromi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Motomu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D064752:Atrial Remodeling; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000959:Antihypertensive Agents