Pulmonary Vascular Remodeling and Prognosis in Patients Evaluated for Heart Transplantation

Objective: In patients with advanced heart failure, the intravascular optical coherence tomography (OCT) of subsegmental pulmonary artery measurements is correlated with right heart catheterization parameters. Our aim was to study the prognostic value of pulmonary OCT, right heart catheterization da...

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Bibliographic Details
Authors: Martínez-Solano, Jorge, Gutiérrez-Ibañes, Enrique, Ortiz-Bautista, Carlos, García-Cosío, María Dolores, Sarnago-Cebada, Fernando, Díaz-Molina, Beatriz|||0000-0002-7773-8121, Pascual, Isaac|||0000-0001-5433-1364, Oteo, Juan F.|||0000-0002-2641-4135, Gómez-Bueno, Manuel|||0000-0002-9764-7518, Calviño-Santos, Ramón, Crespo-Leiro, Maria Generosa|||0000-0002-3085-167X, Gómez-Hospital, Joan Antoni|||0000-0002-3249-3095, Díez-López, Carles|||0000-0002-3734-4777, García-Lara, Juan, Garrido Bravo, Iris, de la Fuente-Galán, Luis, López-Díaz, Javier, Mirabet Pérez, Sonia|||0000-0001-5955-2748, Martínez-Sellés, Manuel|||0000-0003-0289-6229
Format: article
Publication Date:2022
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:283196
Online Access:https://ddd.uab.cat/record/283196
https://dx.doi.org/urn:doi:10.3390/jcdd9120439
Access Level:Open access
Keyword:Pulmonary hypertension
Pulmonary vascular remodeling
Advanced heart failure
Optical coherence tomography
Intravascular imaging
Right heart catheterization
Heart transplant
Description
Summary:Objective: In patients with advanced heart failure, the intravascular optical coherence tomography (OCT) of subsegmental pulmonary artery measurements is correlated with right heart catheterization parameters. Our aim was to study the prognostic value of pulmonary OCT, right heart catheterization data, and the echocardiographic estimation of pulmonary pressure in patients studied for elective heart transplants. Methods: This research is an observational, prospective, multicenter study involving 90 adults with a one-year follow-up. Results: A total of 10 patients (11.1%) died due to worsening heart failure before heart transplantation, 50 underwent a heart transplant (55.6%), and 9 died in the first year after the transplant. The patients with and without events (mortality or heart failure-induced hospitalization) had similar data regarding echocardiography, right heart catheterization, and pulmonary OCT (with a median estimated pulmonary artery systolic pressure of 42.0 mmHg, interquartile range (IQR) of 30.3-50.0 vs. 47.0 mmHg, IQR 34.6-59.5 and p = 0.79, median pulmonary vascular resistance of 2.2 Wood units, IQR 1.3-3.7 vs. 2.0 Wood units, IQR 1.4-3.2 and p = 0.99, and a median pulmonary artery wall thickness of 0.2 ± 0.5 mm vs. 0.2 ± 0.6 mm and p = 0.87). Conclusion: Pulmonary vascular remodeling (evaluated with echocardiography, right heart catheterization, and pulmonary OCT) was not associated with prognosis in a selected sample of adults evaluated for elective heart transplants. Pulmonary OCT is safe and feasible for the evaluation of these patients.

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