Left Ventricular End-Diastolic Dimension and Clinical Outcomes After Centrifugal Flow Left Ventricular Assist Device Implantation.

Autor: Truong VT; From the The Christ Hospital Health Network, Cincinnati, Ohio.; The 'Lindner' Research Center, Cincinnati, Ohio., Shreenivas S; From the The Christ Hospital Health Network, Cincinnati, Ohio., Mazur W; From the The Christ Hospital Health Network, Cincinnati, Ohio., Egnaczyk GF; From the The Christ Hospital Health Network, Cincinnati, Ohio., Palmer C; From the The Christ Hospital Health Network, Cincinnati, Ohio., Rao SD; Advanced Heart Failure/Transplantation Program, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania., Rame JE; Advanced Cardiac and Pulmonary Vascular Disease, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Chung ES; From the The Christ Hospital Health Network, Cincinnati, Ohio.
Jazyk: angličtina
Zdroj: ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2022 Feb 01; Vol. 68 (2), pp. 220-225.
DOI: 10.1097/MAT.0000000000001449
Abstrakt: The impact of preoperative end-diastolic left ventricular dimension (preLVEDD) on long-term outcomes with centrifugal continuous-flow left ventricular assist device (CF-LVAD) is not well established. Accordingly, we performed an analysis of the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registry to study this relationship. All patients with centrifugal CF-LVAD in the INTERMACS registry from June 2006 to December 2017 were screened. The final study group consisted of 3,304 patients. After a median follow-up of 9.0 months (interquartile range [IQR], 4.2-18.8 months), 2,596 (79%) patients were alive. After adjusting for significant covariates, increased preLVEDD was associated with lower mortality (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.84-0.98; p = 0.01), stroke (HR, 0.85; 95% CI, 0.77-0.93; p < 0.001), and gastrointestinal bleeding (HR, 0.88; 95% CI, 0.80-0.97; p = 0.01), although there were more arrhythmias (HR, 1.14; 95% CI, 1.05-1.24; p = 0.003). Our study suggests that preLVEDD is an independent predictor of mortality and adverse events in patients treated with centrifugal CF-LVAD. preLVEDD should be considered an important preimplant variable for risk stratification when considering a CF-LVAD.
Competing Interests: Disclosure: The authors have no conflicts of interest to report.
(Copyright © ASAIO 2021.)
Databáze: MEDLINE