Pre-implant right ventricular free wall strain predicts post-LVAD right heart failure
| Autor: | Malamo E. Countouris, Yeahwa Hong, Floyd Thoma, Keith Dufendach, Arman Kilic, Carlos E Diaz Castrillon, Gavin Hickey, Toby Zhu, Mary E. Keebler |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty Heart Ventricles Ventricular Dysfunction Right 030204 cardiovascular system & hematology Single Center Free wall 03 medical and health sciences 0302 clinical medicine Right heart failure Internal medicine medicine Humans Retrospective Studies Heart Failure Univariate analysis business.industry Odds ratio 030228 respiratory system Echocardiography Circulatory system Cardiology Surgery Implant Heart-Assist Devices Right Ventricular Free Wall Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiac surgeryREFERENCES. 36(6) |
| ISSN: | 1540-8191 |
| Popis: | Background The aim of this study is to evaluate the predictive utility of preoperative right ventricular (RV) global longitudinal strain (GLS) and free wall strain (FWS) on outcomes following left ventricular assist devices (LVADs) implantation. Methods Preoperative transthoracic echocardiograms were retrospectively reviewed in adults undergoing continuous-flow LVAD implantation between 2004 and 2018 at a single center. Patients undergoing pump exchange were excluded. RV GLS and FWS were calculated using commercially available software with the apical four-chamber view. The primary outcome was RV failure as defined by the Interagency Registry for Mechanically Assisted Circulatory Support within 1-year post-LVAD insertion. Results A total of 333 patients underwent continuous-flow LVAD implantation during the study period and 137 had adequate preoperative studies for RV strain evaluation. RV FWS was found to be a significant predictor of postoperative RV failure in univariate analysis (odds ratio [OR] = 1.12, p = .03), and this finding persisted after risk adjustment in multivariable analysis (OR = 1.14, p = .04). Using the optimal cutoff value of -5.64%, the c-index of FWS in predicting RV failure was 0.65. RV GLS was not associated with post-LVAD RV failure (OR = 1.07, p = .29). PCWP was the only additional significant predictor of RV failure using multivariable analysis (OR = 0.90, p = .02). Conclusion Pre-implant RV FWS is predictive of RV failure in the first postoperative year after LVAD implantation. |
| Databáze: | OpenAIRE |
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