Heart recovery and reverse remodeling following lung transplant in pulmonary artery hypertension

Abstract

Abstract Background Pulmonary artery hypertension (PAH) is a progressive disease that result in right heart dysfunction. Lung transplantation (LTx) improve survival in end-stage disease. The aim of this study is to assess heart recovery after LTx for patients with primary and secondary pulmonary hypertension. Methods We conducted a single center retrospective review for patients with primary and secondary PAH underwent LTx between the period of January 2015 and December 2020. Baseline characteristics and echocardiographic measures were assessed pre-operative and after 1 year follow-up. Survival comparison between primary and secondary PAH was estimated by Kaplan–Meier method. Results We identified 43 participants for the study. Among the participants, 11 case had primary PAH. Median age during transplant was 60 years (45.5, 65.5). Left atrium anterio-posterior dimensions, systolic right ventricle pressure tricuspid peal regurgitant velocity and severity of tricuspid regurgitation were found to be significantly improved post-operatively compared to pre-operative echocardiography (p value < 0.05). Overall mortality was not significant between primary and secondary PAH (p value = 0.66). Conclusions LTx can reverse heart remodeling and facilitate recovery in primary and secondary PAH. Our data confirm the importance of LTx as a viable option in PAH failing medical treatment.

Keywords

• Lung transplantation
• Pulmonary artery hypertension
• Echocardiography