Relationship of Baseline Right Ventricle Function with Response to Cardiac Resynchronization Therapy

Abstract

collected FEV1, FVC, FEV1/FVC ratios, and DLCO, as well as the percent predicted (pp) values for each of these parameters. Survival data, incidence of peri-operative right heart failure, and 6 month functional assessments (Kansas City Cardiomyopathy Questionnaire [KCCQ] and six minute walk distance [6MWD]) were also collected. The association of baseline PFT parameter with survival time was tested using proportional hazards regression, adjusted for known predictors of post-LVAD survival. The associations of PFT metrics with improvement in KCCQ and 6MWD were tested using linear regression adjusted for baseline values. Results: The mean cohort age was 54.8 (Range 20 to 75), were 23.3% female (30/129), 51.2% non-white race (66/129), and 52.7% were destination therapy (68/129). There was no association of PFT parameters (FEV1, ppFEV1, FEV1/FVC or DLCO) with survival time post LVAD (all four p-values greater than 0.2485), nor the incidence of peri-operative RV failure (all p O 0.1938). There were no significant associations of the baseline PFT metrics (FEV1, FVC, FEV1/FVC ratio and DLCO) with either the change in KCCQ or change in 6MWD measures, except for ppFEV1 which showed a negative correlation (i.e. low value correlated to better improvement). Conclusions: In this single center study, there was no relationship between baseline PFTs and survival time, RV failure or functional outcomes after LVAD placement. Further studies are needed to explore whether pre-operative pulmonary function testing is useful or necessary in patients being considered for LVAD implantation.