LACK OF LEFT-VENTRICULAR DYSFUNCTION ASSOCIATED WITH SUSTAINED EXPOSURE TO HYPERLIPIDEMIA FOLLOWING LUNG TRANSPLANTATION

Objectives: Hyperlipidemia due to standard immunosuppressive agents oc curs commonly following solid organ transplantation. A decision to tre at hyperlipidemias would be based on the assumption that such disorder s lead to accelerated atherogenesis and ultimately to cardiac dysfunct ion. We therefore sought to examine whether hyperlipidemias following lung transplantation were associated with a decline in left ventricula r (LV) function. Study design: We retrospectively reviewed serial echo cardiograms, radionucleotide angiograms (RNAs), and serum lipid levels following lung transplantation. Results of cardiac studies were defin ed as abnormal if a decline in LV grade occurred from the best result at any time postoperatively to the most recent study, Patients: A tota l of 184 patients with transplants between November 1983 and June 1995 were reviewed. Eighty patients were excluded owing to incomplete data . One patient was excluded because of severe perioperative myocardial dysfunction. Results: Approximately 80% of patients had elevated chole sterol levels and 60% had elevated low-density lipoprotein levels. Tri glyceride levels were raised in 34% of patients while only 4% had an a bnormal serum high-density lipoprotein level. More than 80% of patient s had no evidence of LV abnormalities in either RNA or echocardiograph ic studies (group 1). One patient had a change in echocardiographic LV function but no change in grade of RNA (group 2), Twenty patients had a decline in grade based on RNA but no change in the echocardiogram ( group 3). There were no patients with changes in both RNA and echocard iogram (group 4). All changes in LV function were from grade I to II. The mean period of follow-up exceeded 30 months for patients in groups 1 to 3. Follow-up data at 3, 4, and 5 years were available on 47, 23, and 12 patients, respectively, There were no differences between the proportions of subjects with normal and abnormal serum lipid levels in each group. Conclusions: In the initial 5 rears after lung transplant ation, dyslipidemias affect the majority of patients but are not assoc iated with evidence of deteriorating LV function.