Pulmonary acceleration time to optimize the timing of lung transplant in cystic fibrosis.

Pulmonary Circulation
Thibaud DamyBrigitte Fauroux

Abstract

Pulmonary hypertension (PH) may affect survival in cystic fibrosis (CF) and can be assessed on echocardiographic measurement of the pulmonary acceleration time (PAT). The study aimed at evaluating PAT as a tool to optimize timing of lung transplant in CF patients. Prospective multicenter longitudinal study of patients with forced expiratory volume in 1 second (FEV1) ≤60% predicted. Echocardiography, spirometry and nocturnal oximetry were obtained as part of the routine evaluation. We included 67 patients (mean FEV1 42±12% predicted), among whom 8 underwent lung transplantation during the mean follow-up of 19±6 months. No patients died. PAT was determined in all patients and correlated negatively with systolic pulmonary artery pressure (sPAP, r=-0.36, P=0.01). Patients in the lowest PAT tertile (<101 ms) had lower FEV1 and worse nocturnal oxygen saturation, and they were more often on the lung transplant waiting list compared to patients in the other tertiles. Kaplan-Meier curves showed a shorter time to lung transplantation in the lowest PAT tertile (P<0.001) but not in patients with sPAP>35 mmHg. By multivariate analysis, FEV(1)and nocturnal desaturation were the main determinants of reduced PAT. A PAT<101 ms reduction is a pr...Continue Reading

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Citations

Sep 16, 2014·American Journal of Respiratory and Critical Care Medicine·Don HayesBryan A Whitson
Jan 7, 2014·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Don HayesBryan A Whitson
Sep 21, 2013·Current Opinion in Pulmonary Medicine·Adriano R Tonelli
Dec 2, 2020·Transplantation Proceedings·Vittorio ScaravilliGiacomo Grasselli

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