Open AccessPulmonary Acceleration Time to Optimize the Timing of Lung Transplant in Cystic Fibrosis
Author(s) -
Damy Thibaud,
Burgel PierreRégis,
Pepin JeanLouis,
Boelle PierreYves,
Cracowski Claire,
MurrisEspin Marlène,
NoveJosserand Raphaele,
Stremler Nathalie,
Simon Tabassome,
Adnot Serge,
Fauroux Brigitte
Publication year - 2012
Publication title -
pulmonary circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 40
ISSN - 2045-8940
DOI - 10.4103/2045-8932.94838
Subject(s) - medicine , cardiology , spirometry , lung transplantation , lung , cystic fibrosis , pulmonary hypertension , pulmonary artery , transplantation , asthma
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 promising tool for timing of lung transplantation in CF.