AI Article Synopsis
- Right ventricular (RV) function is a critical indicator of mortality in chronic left-sided heart failure, especially for patients on left ventricular assist devices, as it predicts postoperative RV failure.
- Clinical methods for calculating the RV stroke work index (RVSWI) often underestimate true RV performance by not accounting for factors like regurgitant flow, especially in cases of tricuspid regurgitation.
- By creating single-beat pressure-volume loops from advanced imaging and catheterization data, researchers found that this method improved predictions of RV failure after surgery and highlighted the need for further investigation into these metrics for clinical application.
Article Abstract
Right ventricular (RV) function is an important marker of mortality in chronic left-sided heart failure. Right ventricular function is particularly important for patients receiving left ventricular assist devices as it is a predictor of postoperative RV failure. RV stroke work index (RVSWI), the area enclosed by a pressure-volume (PV) loop, is prognostic of RV failure. However, clinical RVSWI approximates RVSWI as the product of thermodilution-derived stroke volume and the pulmonary pressure gradient. This ignores the energetic contribution of regurgitant flow and does not allow for advanced energetic measures, such as pressure-volume area and efficiency. Estimating RVSWI from forward flow may underestimate the underlying RV function. We created single-beat PV loops by combining data from cine computed tomography (CT) and right heart catheterization in 44 heart failure patients, tested the approximations made by clinical RVSWI and found it to underestimate PV loop RVSWI, primarily due to regurgitant flow in tricuspid regurgitation. The ability of RVSWI to predict post-operative RV failure improved when the single-beat approach was used. Further, RV pressure-volume area and efficiency measures were obtained and show broad agreement with other functional measures. Future work is needed to investigate the utility of these PV metrics in a clinical setting.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892274 | PMC |
| http://dx.doi.org/10.1097/MAT.0000000000001869 | DOI Listing |
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