When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation

被引:3
作者
Schloeglhofer, Thomas [1 ,2 ,3 ]
Wittmann, Franziska [1 ]
Paus, Robert [1 ,3 ]
Riebandt, Julia [1 ]
Schaefer, Anne-Kristin [1 ]
Angleitner, Philipp [1 ]
Granegger, Marcus [1 ]
Aigner, Philipp [2 ,3 ]
Wiedemann, Dominik [1 ]
Laufer, Gunther [1 ]
Schima, Heinrich [1 ,2 ,3 ]
Zimpfer, Daniel [1 ,2 ]
机构
[1] Med Univ Vienna, Dept Cardiac Surg, A-1090 Vienna, Austria
[2] Ludwig Boltzmann Inst Cardiovasc Res, A-1020 Vienna, Austria
[3] Med Univ Vienna, Ctr Med Phys & Biomed Engn, A-1090 Vienna, Austria
来源
LIFE-BASEL | 2022年 / 12卷 / 03期
关键词
ventricular assist device; mechanical circulatory support; right heart failure; risk factor; DECISION-MAKING; BETA-BLOCKERS; PREDICTORS;
D O I
10.3390/life12030459
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Right heart failure (RHF) is a severe complication after left ventricular assist device (LVAD) implantation. The aim of this study was to analyze the incidence, risk factors, and biomarkers for late RHF including the possible superiority of the device and implantation method. This retrospective, single-center study included patients who underwent LVAD implantation between 2014 and 2018. Primary outcome was freedom from RHF over one-year after LVAD implantation; secondary outcomes included pre- and postoperative risk factors and biomarkers for RHF. Of the 145 consecutive patients (HeartMate 3/HVAD: n = 70/75; female: 13.8%), thirty-one patients (21.4%) suffered RHF after a mean LVAD support of median (IQR) 105 (118) days. LVAD implantation method (less invasive: 46.7% vs. 35.1%, p = 0.29) did not differ significantly in patients with or without RHF, whereas the incidence of RHF was lower in HeartMate 3 vs. HVAD patients (12.9% vs. 29.3%, p = 0.016). Multivariate Cox proportional hazard analysis identified HVAD (HR 4.61, 95% CI 1.12-18.98; p = 0.03), early post-op heart rate (HR 0.96, 95% CI 0.93-0.99; p = 0.02), and central venous pressure (CVP) (HR 1.21, 95% CI 1.05-1.39; p = 0.01) as independent risk factors for RHF, but no association of RHF with increased all-cause mortality (HR 1.00, 95% CI 0.99-1.01; p = 0.50) was found. To conclude, HVAD use, lower heart rate, and higher CVP early post-op were independent risk factors for RHF following LVAD implantation.
引用
收藏
页数:15
相关论文
共 50 条
  • [41] Preoperative Evaluation and Perioperative Management of Right Ventricular Failure After Left Ventricular Assist Device Implantation
    Marzec, Lucas N.
    Ambardekar, Amrut V.
    SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2013, 17 (04) : 249 - 261
  • [42] Treatment Strategies and Outcomes of Right Ventricular Failure Post Left Ventricular Assist Device Implantation: An INTERMACS Analysis
    Chamogeorgakis, Themistokles
    Toumpoulis, Ioannis
    Bonios, Michael J.
    Lanfear, David
    Williams, Celeste
    Koliopoulou, Antigoni
    Cowger, Jennifer
    ASAIO JOURNAL, 2024, 70 (04) : 264 - 271
  • [43] Preoperative predictors and outcomes of right ventricular assist device implantation after continuous-flow left ventricular assist device implantation
    Patil, Nikhil Prakash
    Mohite, Prashant N.
    Sabashnikov, Anton
    Dhar, Dhruva
    Weymann, Alexander
    Zeriouh, Mohamed
    Hards, Rachel
    Hedger, Michael
    De Robertis, Fabio
    Bahrami, Toufan
    Amrani, Mohamed
    Rahman-Haley, Shelley
    Banner, Nicholas R.
    Popov, Aron Frederik
    Simon, Andre Ruediger
    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2015, 150 (06) : 1651 - 1658
  • [44] Liberal Right Ventricular Assist Device Extracorporeal Membrane Oxygenation Support for Right Ventricular Failure after Implantable Left Ventricular Assist Device Placement
    Fischer, Quentin
    Kirsch, Matthias
    ASAIO JOURNAL, 2018, 64 (06) : 741 - 747
  • [45] Right Ventricular Strain to Assess Early Right Heart Failure in the Left Ventricular Assist Device Candidate
    Gumus, Fatih
    Saricaoglu, Cahit
    Inan, Mustafa Bahadir
    Akar, Ahmet Ruchan
    CURRENT HEART FAILURE REPORTS, 2019, 16 (06) : 212 - 219
  • [46] Can Perioperative Right Ventricular Support Prevent Postoperative Right Heart Failure in Patients With Biventricular Dysfunction Undergoing Left Ventricular Assist Device Implantation?
    Deschka, Heinz
    Holthaus, Alexander J.
    Sindermann, Juergen R.
    Welp, Henryk
    Schlarb, Dominik
    Monsefi, Nadejda
    Martens, Sven
    Scherer, Mirela
    JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2016, 30 (03) : 619 - 626
  • [47] Right-ventricular failure following left ventricle assist device implantation
    Patlolla, Bhagat
    Beygui, Ramin
    Haddad, Francois
    CURRENT OPINION IN CARDIOLOGY, 2013, 28 (02) : 223 - 233
  • [48] Right Ventricular Global Longitudinal Strain as a Predictor of Acute and Early Right Heart Failure Post Left Ventricular Assist Device Implantation
    Liang, Lusha W.
    Jamil, Alisha
    Mazurek, Jeremy A.
    Urgo, Kimberly A.
    Wald, Joyce
    Birati, Edo Y.
    Han, Yuchi
    ASAIO JOURNAL, 2022, 68 (03) : 333 - 339
  • [49] Right Heart Failure After Left Ventricular Assist Device Placement Medical and Surgical Management Considerations
    Pagani, Francis D.
    CARDIOLOGY CLINICS, 2020, 38 (02) : 227 - +
  • [50] Left ventricular vs. biventricular mechanical support: Decision making and strategies for avoidance of right heart failure after left ventricular assist device implantation
    Dandel, Michael
    Krabatsch, Thomas
    Falk, Volkmar
    INTERNATIONAL JOURNAL OF CARDIOLOGY, 2015, 198 : 241 - 250