Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital

Lung diffusion capacity in advanced heart failure: relation to central haemodynamics and outcome

Research output: Contribution to journalJournal articleResearchpeer-review


  1. Cardiomyopathy and kidney function in agalsidase beta-treated female Fabry patients: a pre-treatment vs. post-treatment analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Fibroblast growth factor 21 in patients with cardiac cachexia: a possible role of chronic inflammation

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Rationale and design of the EU-CERT-ICD prospective study: comparative effectiveness of prophylactic ICD implantation

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Impact of an interatrial shunt device on survival and heart failure hospitalization in patients with preserved ejection fraction

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS: Patients with heart failure (HF) are known to have a reduced pulmonary diffusion capacity for carbon monoxide (DLCO ), but little is known about how lung function relates to central haemodynamics. The aim of this study was to investigate the association between haemodynamic variables and pulmonary diffusion capacity adjusted for alveolar volume in congestive HF patients and to analyse how predicted DLCO /VA affects mortality in relation to the haemodynamic status.

METHODS AND RESULTS: We retrospectively studied right heart catheterization (RHC) and lung function data on 262 HF patients (mean age 51 ± 13 years) with a left ventricular ejection fraction < 45% referred non-urgently for evaluation for heart transplantation (HTX) or left ventricular assist device (LVAD). Univariate and multivariate linear regression models were constructed to examine the associations between predicted values of DLCO /VA , forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1 ), and haemodynamic parameters [pulmonary capillary wedge pressure (PCWP), central venous pressure, cardiac index, mean pulmonary artery pressure, and mean arterial pressure] as well as other factors known to affect lung function in HF. FEV1 was reduced to <80% of predicted value in 55% of the population, and DLCO/ VA was reduced in 63% of the population. DLCO /VA correlated positively with pulmonary capillary wedge pressure in both univariate and multivariate analyses for all included patients (P < 0.001 and P = 0.045, respectively) and a restricted population of patients with the shortest time between RHC and lung function testing (P = 0.005, P = 0.015). DLCO /VA predicted mortality in multivariate models [hazard ratio 1.5 (1.1-2.1)] but not the combined endpoint of death, LVAD implantation, or HTX. There was no significant correlation between haemodynamics and predicted FVC or FEV1 .

CONCLUSIONS: Pulmonary diffusion capacity correlates positively with left ventricular fillings pressures, and reduced values predict increased mortality in patients with HF. This might be driven by increased lung capillary volume in patients with pulmonary congestion.

Original languageEnglish
JournalESC Heart Failure
Issue number2
Pages (from-to)379-387
Number of pages9
Publication statusPublished - Apr 2019

    Research areas

  • Denmark/epidemiology, Female, Follow-Up Studies, Forced Expiratory Volume/physiology, Heart Failure/diagnosis, Hemodynamics, Humans, Male, Middle Aged, Pulmonary Circulation/physiology, Pulmonary Diffusing Capacity, Pulmonary Wedge Pressure/physiology, Respiratory Function Tests, Retrospective Studies, Survival Rate/trends, Ventricular Function, Left, Heart failure, Pulmonary diffusion capacity, Right heart catheterization, Haemodynamics

ID: 57664053