Author + information
- Amy French,
- Michael Kiernan,
- David DeNofrio,
- Duc Thinh Pham,
- Navin Kapur,
- Natesa Pandian and
- Ayan Patel
Right ventricular failure (RVF) is associated with significant morbidity following left ventricular assist device (LVAD) surgery. Hemodynamic, clinical, and 2-dimensional echocardiographic variables poorly discriminate patients at risk of RVF. We examined the utility of 3-dimensional echocardiography (3DE) right ventricular (RV) volumetric assessment to identify patients at risk of RVF.
RVF was defined as the need for inotropic infusion for >14 days following LVAD surgery or RV assist device (RVAD) placement. Preoperative RV volumes and ejection fraction (RVEF) were measured, blinded to clinical data, from transthoracic 3DE full volume data sets in 29 patients. Univariate analyses were used to compare baseline variables and 3DE RV indices among patients with and without RVF. Multivariate logistic regression was used to adjust for baseline covariates.
Twenty-five patients (86%) received continuous flow LVADs. Thirteen patients (45%) had RVF; 2 required RVAD support and 11 required prolonged inotropes. Cardiac index, RV stroke work index (RVSWI), indexed RV end diastolic and systolic volumes (RVEDVI & RVESVI) and RVEF were associated with RVF (Table 1). RVEDVI (OR 1.082 (1.00, 1.17), p=0.049) and RVESVI (OR 1.117 (1.00, 1.25), p=0.049) remained associated with RVF after adjusting for RVSWI.
Quantitative 3DE is a promising method for pre-LVAD RV assessment. RV volumes assessed by 3DE are predictive of RVF in LVAD recipients, independent of RVSWI.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Mechanical Circulatory Support: Assessment of Risk and Outcomes
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1307M-287
- 2013 American College of Cardiology Foundation