Remodelado cardíaco inverso en pacientes con hipertensión pulmonar tras trasplante bipulmonar. Estudio con tomografía computarizada multidetector / Multidetector computed tomography shows reverse cardiac remodeling after double lung transplantation for pulmonary hypertension

Objetivo. Valorar mediante tomografía computarizada multidetector (TCMD) los cambios estructurales del corazón derecho y de las arterias pulmonares que se producen en los pacientes con hipertensión pulmonar (HP) grave tratados mediante trasplante bipulmonar (TxBP). Material y métodos. Estudio retrospectivo de 21 pacientes consecutivos diagnosticados de HP grave, a los que se realizó TxBP en nuestro centro hospitalario durante los años 2010-2014. Se analizó la TCMD realizada previa al trasplante pulmonar, y la primera disponible después. Se obtuvieron las siguientes variables: diámetro del tronco de la arteria pulmonar, relación diámetro tronco de la arteria pulmonar/diámetro de la aorta ascendente, diámetro del ventrículo derecho, relación diámetro ventrículo izquierdo/derecho e índice de excentricidad. Se realizó un análisis estadístico con comparación de medias de las diferentes variables recogidas. Resultados. En todos los casos analizados se observó, en la TCMD realizada, una media de 24±14 días post-TxBP, una reducción significativa del tamaño de las cavidades derechas, con mejoría de los índices de interdependencia ventricular y del tamaño del tronco de la arteria pulmonar (p<0,001 para todas las variables analizadas). Conclusión. Los pacientes con HP tratados mediante TxBP presentan un remodelado inverso precoz de los cambios estructurales cardíacos derechos y del árbol arterial pulmonar. La TCMD es útil para detectar dichos cambios (AU)

Objective. To use multidetector computed tomography (MDCT) to evaluate the structural changes in the right heart and pulmonary arteries that occur in patients with severe pulmonary hypertension treated by double lung transplantation. Material and methods. This was a retrospective study of 21 consecutive patients diagnosed with severe pulmonary hypertension who underwent double lung transplantation at our center between 2010 and 2014. We analyzed the last MDCT study done before lung transplantation and the first MDCT study done after lung transplantation. We recorded the following variables: diameter of the pulmonary artery trunk, ratio of the diameter of the pulmonary artery trunk to the diameter of the ascending aorta, diameter of the right ventricle, ratio of the diameter of the left ventricle to the diameter of the right ventricle, and eccentricity index. Statistical analysis consisted of the comparison of the means of the variables recorded. Results. In all cases analyzed, the MDCT study done a mean of 24±14 days after double lung transplantation showed a significant reduction in the size of the right heart chambers, with improved indices of ventricular interdependency index, and reduction in the size of the pulmonary artery trunk (p<0.001 for all the variables analyzed). Conclusion. Patients with pulmonary hypertension treated by double lung transplantation present early reverse remodeling of the changes in the structures of the right heart and pulmonary arterial tree. MDCT is useful for detecting these changes (AU)

Multidetector computed tomography shows reverse cardiac remodeling after double lung transplantation for pulmonary hypertension. / Remodelado cardíaco inverso en pacientes con hipertensión pulmonar tras trasplante bipulmonar. Estudio con tomografía computarizada multidetector.

OBJECTIVE: To use multidetector computed tomography (MDCT) to evaluate the structural changes in the right heart and pulmonary arteries that occur in patients with severe pulmonary hypertension treated by double lung transplantation. MATERIAL AND METHODS: This was a retrospective study of 21 consecutive patients diagnosed with severe pulmonary hypertension who underwent double lung transplantation at our center between 2010 and 2014. We analyzed the last MDCT study done before lung transplantation and the first MDCT study done after lung transplantation. We recorded the following variables: diameter of the pulmonary artery trunk, ratio of the diameter of the pulmonary artery trunk to the diameter of the ascending aorta, diameter of the right ventricle, ratio of the diameter of the left ventricle to the diameter of the right ventricle, and eccentricity index. Statistical analysis consisted of the comparison of the means of the variables recorded. RESULTS: In all cases analyzed, the MDCT study done a mean of 24±14 days after double lung transplantation showed a significant reduction in the size of the right heart chambers, with improved indices of ventricular interdependency index, and reduction in the size of the pulmonary artery trunk (p<0.001 for all the variables analyzed). CONCLUSION: Patients with pulmonary hypertension treated by double lung transplantation present early reverse remodeling of the changes in the structures of the right heart and pulmonary arterial tree. MDCT is useful for detecting these changes.