LUNG VENTILATION EFFICIENCY AND QUALITY OF LIFE AFTER ORTHOTOPIC HEART TRANSPLANTATION

Aim of the study was assessment of efficiency of lung ventilation and its relationship with quality of life in patients undergoing orthotopic heart transplantation (OHT). Materials and methods. The study involved 40 patients with terminal chronic heart failure (CHF) included in the waiting list for heart transplantation. Before surgery and after OHT all patients underwent cardiopulmonary exercise testing, evaluation of clinical status and quality of life (QL) according to the 36-Item Short Form Survey (SF-36). Results. During the follow-up period (5 years) after OHT there were a significant increase in physical capacity, two-fold increase of peak oxygen consumption (VO2), normalization of VE/VCO2 slope level, improvement of the efficiency of the VO2 recovery within first minute and reduction of the VO2 recovery time. OHT was associated with significant improvement of physical and mental health components of QL. Among exercise test parameters significantly associated with improved physical health component of QL were increments in exercise capacity, peak V02, rate of VO2 recovery within first minute. There was no relationship between cardiopulmonary parameters of exercise test and mental health component of QL. Conclusion. In patients with terminal CHF OHR led to significant increase of the lung ventilation efficiency and QL. Factors contributing to QL improvement after OHT were augmentation of left ventricular ejection fraction and reduction of CHF NYHA class. Among cardiopulmonary exercise test parameters, a high predictive value relative to improvement of subjective assessment of physical health component of QL showed exercise capacity, peak VO2, and efficiency of VO2 recovery within first minute.