Right Ventricular Systolic and Diastolic Function as Assessed by Speckle-Tracking Echocardiography Improve With Prolonged Isolated Left Ventricular Assist Device Support

Background: Right ventricular (RV) failure is a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Whether RV function deteriorates with prolonged LVAD support is unknown. Speckle-tracking echocardiography provides a sensitive, noninvasive, reproducible, and quantitative assessment of RV systolic and diastolic function. Methods: Echocardiograms were retrospectively reviewed from before and after implantation of a Heartmate II LVAD. Speckle-tracking analysis was performed to measure RV longitudinal systolic strain, strain rate, and diastolic strain rate for each patient at baseline and over discrete time periods after LVAD implantation. Results: Seventeen patients were included in the analysis, with an average follow-up after LVAD implantation of 234 125 days. RV systolic strain improved in 15 patients, decreasing from 7.4 +/- 2.3% to -9.7 +/- 3.3% after LVAD (P = .026). Systolic strain rate improved in 11 patients, decreasing from -0.67 +/- 0.25%/s to -0.96 +/- 0.36%/s (P = .011). RV diastolic strain rate improved in 12 patients, increasing from 0.70 +/- 0.33%/s to 1.02 +/- 0.40%/s (P = .016). Conclusions: Chronic LVAD support improves RV systolic and diastolic function in LVAD patients who did not require an RV assist device. Speckle-tracking echocardiography may offer a noninvasive technique for identifying and monitoring improvements in RV function in LVAD patients.