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. 2017 Nov 27;12(11):e0188383.
doi: 10.1371/journal.pone.0188383. eCollection 2017.

Persistent abnormalities in pulmonary arterial compliance after heart transplantation in patients with combined post-capillary and pre-capillary pulmonary hypertension

Stefano Ghio  1 , Gabriele Crimi  1 , Silvia Pica  1 , Pier Luigi Temporelli  2 , Massimo Boffini  3 , Mauro Rinaldi  3 , Claudia Raineri  1 , Laura Scelsi  1 , Massimo Pistono  2 , Rossana Totaro  1 , Stefania Guida  1 , Luigi Oltrona Visconti  1
Affiliations

Persistent abnormalities in pulmonary arterial compliance after heart transplantation in patients with combined post-capillary and pre-capillary pulmonary hypertension

Stefano Ghio et al. PLoS One. .

Erratum in

Abstract

Background: The hemodynamic definitions of pulmonary hypertension (PH) in left heart disease have recently been refined to better match the characteristics required to reflect the presence of pulmonary vascular disease. Accordingly, we tested the hypothesis that abnormalities in the stiffness of pulmonary circulation would persist after heart transplantation in patients with combined post-capillary and pre-capillary PH (Cpc-PH) in contrast to those with isolated post-capillary PH (Ipc-PH).

Methods: We retrospectively analyzed right heart hemodynamics in a cohort of 295 consecutive patients with heart failure and advanced left ventricular systolic dysfunction (LVSD) before and 1 year after heart transplantation.

Results: According to their baseline hemodynamic profile, patients were classified as: 75 Cpc-PH, 111 Ipc-PH, and 98 without PH (no-PH), and 11 pre-capillary PH. One year after heart transplantation, pulmonary artery pressures, pulmonary vascular resistance and cardiac index normalized in all patients regardless of the baseline hemodynamic profile. However, pulmonary arterial compliance remained lower in Cpc-PH patients (from 1.6±1.2 at baseline to 3.7±1.4 ml/mmHg at 1 year) than in Ipc-PH (from 1.2±2.0 to 4.4±2.3 ml/mmHg) and no-PH patients (from 3.7±2.0 to 4.5±1.8 ml/mmHg); (adjusted p = 0.03 Ipc-PH vs. Cpc-PH INT<0.001).

Conclusions: In heart failure patients with advanced LVSD, a hemodynamic profile characterized by Cpc-PH predicts the persistence of a stiffer pulmonary circulation at 1 year after heart transplantation.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PCa vs. PVR data at baseline and after transplant in the entire cohort.
Red dots indicate baseline values, green dots data at 1 month and blue dots data at 1 year after transplant.
Fig 2
Fig 2. PCa changes in the different patient subgroups.
Four hemodynamic subgroups are shown: Cpc-PH, Ipc-PH, patients without PH (no PH) and patients with pre-capillary PH (preC-PH).
Fig 3
Fig 3. PCa vs. PVR data at baseline and 1 year after transplantation in the different subgroups.
Four hemodynamic subgroups are shown: Cpc-PH, Ipc-PH, patients without PH (no PH) and patients with pre-capillary PH (preC-PH).
See this image and copyright information in PMC

References

    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ et al. Authors/Task Force Members. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200. 10.1093/eurheartj/ehw128 - DOI - PubMed
    1. Naeije R, Vachiery J, Yerly P, Vanderpool R. The trans]pulmonary pressure gradient for the diagnosis of pulmonary vascular disease. Eur Respir J. 2013;41:217–223. 10.1183/09031936.00074312 - DOI - PubMed
    1. Gerges C, Gerges M, Lang MB, Zhang Y, Jakowitsch J, Probst P, et al. Diastolic pulmonary vascular pressure gradient: A predictor of prognosis in “out-of-proportion” pulmonary hypertension. Chest. 2013;143:758–766. 10.1378/chest.12-1653 - DOI - PubMed
    1. Bonderman D, Martischnig AM, Vonbank K, Nikfardjam M, Meyer B, Heinz G, et al. Right ventricular load at exercise is a cause of persistent exercise limitation in patients with normal resting pulmonary vascular resistance after pulmonary endarterectomy. Chest. 2011;139:122–127. 10.1378/chest.10-0348 - DOI - PubMed
    1. Ghio S, Morsolini M, Corsico A, Klersy C, Mattiucci G, Raineri C, et al. Pulmonary arterial compliance and exercise capacity after pulmonary endarterectomy. Eur Respir J. 2014;43:1403–1409. 10.1183/09031936.00195313 - DOI - PubMed