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Pulmonary Vascular Remodeling and Prognosis in Patients Evaluated for Heart Transplantation: Insights from the OCTOPUS-CHF Study

2022; Multidisciplinary Digital Publishing Institute; Volume: 9; Issue: 12 Linguagem: Inglês

10.3390/jcdd9120439

2308-3425

Jorge Martínez-Solano, Enrique Gutiérrez, Carlos Ortiz‐Bautista, María Dolores García‐Cosío Carmena, Fernando Sarnago‐Cebada, Beatriz Díaz‐Molina, Isaac Pascual, J. Domínguez, Manuel Gómez‐Bueno, Ramón Calviño‐Santos, María G. Crespo‐Leiro, Joan Antoni Gómez‐Hospital, Carles Díez‐López, Juan García‐Lara, Iris P. Garrido‐Bravo, Luis de la Fuente, Javier López, Sònia Mirabet, Manuel Martínez‐Sellés,

Transplantation: Methods and Outcomes

In patients with advanced heart failure, the intravascular optical coherence tomography (OCT) of subsegmental pulmonary artery measurements is correlated with right heart catheterization parameters. Our aim was to study the prognostic value of pulmonary OCT, right heart catheterization data, and the echocardiographic estimation of pulmonary pressure in patients studied for elective heart transplants.This research is an observational, prospective, multicenter study involving 90 adults with a one-year follow-up.A total of 10 patients (11.1%) died due to worsening heart failure before heart transplantation, 50 underwent a heart transplant (55.6%), and 9 died in the first year after the transplant. The patients with and without events (mortality or heart failure-induced hospitalization) had similar data regarding echocardiography, right heart catheterization, and pulmonary OCT (with a median estimated pulmonary artery systolic pressure of 42.0 mmHg, interquartile range (IQR) of 30.3-50.0 vs. 47.0 mmHg, IQR 34.6-59.5 and p = 0.79, median pulmonary vascular resistance of 2.2 Wood units, IQR 1.3-3.7 vs. 2.0 Wood units, IQR 1.4-3.2 and p = 0.99, and a median pulmonary artery wall thickness of 0.2 ± 0.5 mm vs. 0.2 ± 0.6 mm and p = 0.87).Pulmonary vascular remodeling (evaluated with echocardiography, right heart catheterization, and pulmonary OCT) was not associated with prognosis in a selected sample of adults evaluated for elective heart transplants. Pulmonary OCT is safe and feasible for the evaluation of these patients.