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Related Concept Videos

Pulmonary Function Tests01:25

Pulmonary Function Tests

464
Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
464

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Pulmonary Function Testing Pre-heart Transplant Predicts Posttransplant Survival.

Scott W Lundgren1, Brian D Lowes1, Elizabeth Lyden2

  • 1Department of Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, NE.

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Pulmonary function testing (PFT) before heart transplant, specifically low forced expiratory volume (FEV1) or forced vital capacity (FVC) below 50%, predicts higher mortality and longer hospital stays post-transplant.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Transplant Surgery

Background:

  • Pulmonary function testing (PFT) is standard for heart transplant evaluation.
  • The prognostic value of PFTs after heart transplantation remains unclear.

Purpose of the Study:

  • To investigate the correlation between pre-transplant PFT parameters and post-heart transplant outcomes.
  • To determine if PFTs can predict survival and length of stay after heart transplantation.

Main Methods:

  • Utilized data from the International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry.
  • Assessed survival using Kaplan-Meier and log-rank tests.
  • Employed Cox proportional hazard modeling for univariate and multivariate survival predictor analysis.

Main Results:

  • Pre-transplant FEV1 < 50% predicted and FVC < 50% predicted were significantly associated with higher mortality.
  • Both reduced FEV1 and FVC also predicted longer hospital lengths of stay.
  • FEV1/FVC ratio < 0.7 did not correlate with increased mortality.
  • FEV1 < 50% (HR 4.91) and FVC < 50% (HR 2.75) remained independent predictors of mortality after multivariable adjustment.

Conclusions:

  • Abnormal pre-heart transplant pulmonary function, defined as FEV1 or FVC below 50% of predicted, is linked to increased post-transplant mortality.
  • Severely impaired pulmonary function pre-transplant is also associated with longer hospital stays after heart transplantation.