Right Ventricular Global Longitudinal Strain as a Predictor of Acute and Early Right Heart Failure Post Left Ventricular Assist Device Implantation

Lusha W. Liang, Alisha Jamil, Jeremy A. Mazurek, Kimberly A. Urgo, Joyce Wald, Edo Y. Birati, Yuchi Han

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Early right heart failure (RHF) occurs in up to 40% of patients following left ventricular assist device (LVAD) implantation and is associated with increased morbidity and mortality. The most recent report from the Mechanical Circulatory Support-Academic Research Consortium (MCS-ARC) working group subdivides early RHF into early acute RHF and early postimplant RHF. We sought to determine the effectiveness of right ventricular (RV) longitudinal strain (LS) in predicting RHF according to the new MCS-ARC definition. We retrospectively analyzed clinical and echocardiographic data of patients who underwent LVAD implantation between 2015 and 2018. RVLS in the 4-chamber (4ch), RV outflow tract, and subcostal views were measured on pre-LVAD echocardiograms. Fifty-five patients were included in this study. Six patients (11%) suffered early acute RHF, requiring concomitant RVAD implantation intraoperatively. Twenty-two patients (40%) had postimplant RHF. RVLS was significantly reduced in patients who developed early acute and postimplant RHF. At a cutoff of -9.7%, 4ch RVLS had a sensitivity of 88.9% and a specificity of 77.8% for predicting RHF and area under the receiver operating characteristic curve of 0.86 (95% confidence interval 0.76-0.97). Echocardiographic RV strain outperformed more invasive hemodynamic measures and clinical parameters in predicting RHF.

Original languageEnglish
Pages (from-to)333-339
Number of pages7
JournalASAIO Journal
Volume68
Issue number3
DOIs
StatePublished - 1 Mar 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

Funding

Disclosure: Research reported in this publication was in part supported by the National Institutes of Health R01HL132130 to Y.H. The other authors have no conflicts of interest to report.

FundersFunder number
National Institutes of HealthR01HL132130

    Keywords

    • early right heart failure
    • left ventricular assist device
    • right ventricular strain

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