Right ventricular response to pulsatile load is associated with early right heart failure and mortality after left ventricular assist device.
Publication/Presentation Date
1-1-2017
Abstract
BACKGROUND: Right ventricular (RV) adaptation to afterload is crucial for patients undergoing continuous-flow left ventricular assist device (cf-LVAD) implantation. We hypothesized that stratifying patients by RV pulsatile load, using pulmonary arterial compliance (PAC), and RV response to load, using the ratio of central venous to pulmonary capillary wedge pressure (CVP:PCWP), would identify patients at high risk for early right heart failure (RHF) and 6-month mortality after cf-LVAD.
METHODS: During the period from January 2008 to June 2014, we identified 151 patients at our center with complete hemodynamics prior to cf-LVAD. Pulsatile load was estimated using PAC indexed to body surface area (BSA), according to the formula: indexed PAC (PACi) = [SV / (PA
RESULTS: Sixty-one patients (40.4%) developed RHF and 34 patients (22.5%) died within 6 months. Patients with RHF had lower PACi (0.92 vs 1.17 ml/mm Hg/m
CONCLUSIONS: A hemodynamic profile combining RV pulsatile load and response to load identifies patients at high risk for RHF and 6-month mortality after cf-LVAD.
Volume
36
Issue
1
First Page
97
Last Page
105
ISSN
1557-3117
Published In/Presented At
Grandin, E. W., Zamani, P., Mazurek, J. A., Troutman, G. S., Birati, E. Y., Vorovich, E., Chirinos, J. A., Tedford, R. J., Margulies, K. B., Atluri, P., & Rame, J. E. (2017). Right ventricular response to pulsatile load is associated with early right heart failure and mortality after left ventricular assist device. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 36(1), 97–105. https://doi.org/10.1016/j.healun.2016.06.015
Disciplines
Medicine and Health Sciences
PubMedID
27469015
Department(s)
Department of Surgery
Document Type
Article