Author + information
- Anthony Peters,
- Lavone Smith,
- Jamie Kennedy,
- Mohammad Abuannadi,
- James Bergin and
- Sula Mazimba
Right ventricular failure (RVF) portends poor outcomes after left ventricular assist device (LVAD) implantation. Numerous RVF predictive models have been developed. There are, however, few independent comparative analyses of RVF risk models.
Patients implanted with LVADs from 2011 to 2016 at the University of Virginia were retrospectively reviewed. RVF was defined as use of inotropes for >14 days, inhaled pulmonary vasodilators for >48 hours or unplanned right ventricular mechanical support post-operatively. RVF risk models were evaluated for the primary outcome of RVF using logistic regression and receiver operating curves.
Among 91 LVAD patients with complete data, the Michigan RVF score (c-statistic 0.7688, Figure) compared favorably with newer RVF risk scores (Utah, Pitt, Euromacs) and was also superior to individual hemodynamic/echocardiographic metrics - pulmonary artery pulsatility index (PAPi), pre-operative right ventricular dysfunction (RVD), right atrial pressure, and pulmonary vascular resistance. PAPi and pre-operative RVD were the strongest individual predictors of RVF. The Michigan RVF score was also the best predictor of in-hospital mortality (c-statistic 0.6994) and long-term survival (Figure, Kaplan-Meier log-rank 0.0135).
While several new models and metrics provide predictive value, the more established Michigan RVF score remains a superior predictor of postoperative RVF as well as short-term and long-term mortality.
Poster Hall, Hall A/B
Monday, March 12, 2018, 9:45 a.m.-10:30 a.m.
Session Title: Emerging Strategies, Ventricular Assist Devices and Transplantation
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1279-096
- 2018 American College of Cardiology Foundation