AI Article Synopsis
- Right heart failure (RHF) after LVAD implantation can lead to serious complications and is often assessed using existing risk scores that only partially evaluate right ventricular (RV) dysfunction.
- A study involving 158 patients analyzed quantitative RV parameters, finding that certain metrics like RV end-diastolic area index and RV longitudinal strain significantly correlated with early RHF and improved risk stratification compared to conventional scores.
- The research concluded that measuring RV size and function provides valuable prognostic information for predicting RHF in patients post-LVAD surgery.
Article Abstract
Background: Right heart failure (RHF) after left ventricular assist device (LVAD) implantation is associated with high morbidity and mortality. Existing risk scores include semiquantitative evaluation of right ventricular (RV) dysfunction. This study aimed to determine whether quantitative evaluation of both RV size and function improve risk stratification for RHF after LVAD implantation beyond validated scores.
Methods And Results: From 2009 to 2015, 158 patients who underwent implantation of continuous-flow devices who had complete echocardiographic and hemodynamic data were included. Quantitative RV parameters included RV end-diastolic (RVEDAI) and end-systolic area index, RV free-wall longitudinal strain (RVLS), fractional area change, tricuspid annular plane systolic excursion, and right atrial area and pressure. Independent correlates of early RHF (<30 days) were determined with the use of logistic regression analysis. Mean age was 56 ± 13 years, with 79% male; 49% had INTERMACS profiles ≤2. RHF occurred in 60 patients (38%), with 20 (13%) requiring right ventricular assist device. On multivariate analysis, INTERMACS profiles (adjusted odds ratio 2.38 [95% confidence interval [CI] 1.47-3.85]), RVEDAI (1.61 [1.08-2.32]), and RVLS (2.72 [1.65-4.51]) were independent correlates of RHF (all P < .05). Both RVLS and RVEDAI were incremental to validated risk scores (including the EUROMACS score) for early RHF after LVAD (all P < .01).
Conclusions: RV end-diastolic and strain are complementary prognostic markers of RHF after LVAD implantation.
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| http://dx.doi.org/10.1016/j.cardfail.2018.10.012 | DOI Listing |
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