Effects of left ventricular assist device on pulmonary functions and pulmonary hemodynamics: A meta-analysis

Authors

Waqas Ullah, Abington Jefferson HealthFollow
Casey Meizinger, Abington Jefferson HealthFollow
Zain Ali, Abington Jefferson HealthFollow
Ankur Panchal, University of Pittsburgh
Rehan Saeed, Abington Jefferson HealthFollow
Donald C. Haas, Abington Jefferson HealthFollow
Eduardo Rame, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

11-26-2020

Comments

This article is the author’s final published version in World Journal of Cardiology, Volume 12, Issue 11, November 2020, Pages 550-558.

The published version is available at https://doi.org/10.4330/WJC.V12.I11.550. Copyright © Ullah et al.

Abstract

BACKGROUND: Given current evidence, the effect of left ventricular assist device (LVAD) implantation on pulmonary function tests remains controversial.

AIM: To better understand the factors contributing to the changes seen on pulmonary function testing and the correlation with pulmonary hemodynamics after LVAD implantation.

METHODS: Electronic databases were queried to identify relevant articles. The summary effect size was estimated as a difference of overall means and standard deviation on a random-effects model.

RESULTS: A total of four studies comprising 219 patients were included. The overall mean forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and diffusion lung capacity of carbon monoxide (DLCO) after LVAD implantation were significantly lower by 0.23 L (95%CI: 0.11-0.34, P = 00002), 0.18 L (95%CI: 0.03-0.34, P = 0.02), and 3.16 mmol/min (95%CI: 2.17-4.14, P < 0.00001), respectively. The net post-LVAD mean value of the cardiac index was significantly higher by 0.49 L/min/m² (95%CI: 0.31-0.66, P < 0.00001) compared to pre-LVAD value. The pulmonary capillary wedge pressure and pulmonary vascular resistance were significantly reduced after LVAD implantation by 8.56 mmHg (95%CI: 3.78-13.35, P = 0.0004), and 0.83 Woods U (95%CI: 0.11-1.55, P = 0.02), respectively. There was no significant difference observed in the right atrial pressure after LVAD implantation (0.61 mmHg, 95%CI: -2.00 to 3.32, P = 0.65). Overall findings appear to be driven by studies using HeartMateII devices.

CONCLUSION: LVAD implantation might be associated with a significant reduction of the spirometric measures, including FEV1, FVC, and DLCO, and an overall improvement of pulmonary hemodynamics.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Ullah, Waqas; Meizinger, Casey; Ali, Zain; Panchal, Ankur; Saeed, Rehan; Haas, Donald C.; and Rame, Eduardo, "Effects of left ventricular assist device on pulmonary functions and pulmonary hemodynamics: A meta-analysis" (2020). Abington Jefferson Health Papers. Paper 56.
https://jdc.jefferson.edu/abingtonfp/56

PubMed ID

33312440

Language

English