Occult right ventricular dysfunction and right ventricular-vascular uncoupling in left ventricular assist device recipients

Scheel, Paul J; Cubero Salazar, Ilton M.; Friedman, Samuel; Haber, Leora; Mukherjee, Monica; Kauffman, Matthew; Weller, Alexandra; Alkhunaizi, Fatimah; Gilotra, Nisha A.; Sharma, Kavita; Kilic, Ahmet; Hassoun, Paul M.; Cornwell, William K.; Tedford, Ryan J.; Hsu, Steven

doi:10.1016/j.healun.2023.11.015

Cited by 4 publications

(1 citation statement)

References 38 publications

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“…In addition, the identification of RV dysfunction with LVAD can be challenging with traditional hemodynamic parameters. In this context, RV PV loops provide added benefit in the assessment of RV function in LVAD patients 8 . Our group introduced a catheterization protocol combining both left heart catheterization (LHC) and RHC to provide unique insights into LV unloading and RV function 9 .…”

Section: Introductionmentioning

confidence: 99%

Biventricular catheterization combined with pressure‐volume loop monitoring provides insight into the dynamic effects of left ventricular assist devices ramp on right ventricular function

Garmany,

Inglis,

Behfar

et al. 2024

Cathet Cardio Intervent

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Ramp studies are utilized for speed optimization of continuous flow left ventricular assist devices (CF‐LVADs). We here report the utility of combined left and right heart catheterization during a ramp study to ensure a comprehensive understanding of the hemodynamic implications on both ventricles. Pressure‐volume loop (PV loop) monitoring uncovered compromised systolic and mildly compromised right ventricular function with increasing LVAD speeds, despite improvement in left ventricular unloading. These findings informed patient management and highlight the potential utility of PV loop monitoring as an adjunct to left and right heart catheterization during ramp studies of next‐generation LVADs.

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Section: Introductionmentioning

confidence: 99%

Biventricular catheterization combined with pressure‐volume loop monitoring provides insight into the dynamic effects of left ventricular assist devices ramp on right ventricular function

Garmany,

Inglis,

Behfar

et al. 2024

Cathet Cardio Intervent

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Non‐invasive surrogates for right Ventricular‐Pulmonary arterial coupling: a systematic review and Meta‐Analysis

Golbin,

Shukla,

Nero

et al. 2024

Pulm. circ.

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Right ventricle‐pulmonary artery (RV‐PA) coupling describes the energetic relationship between RV contractility and its afterload. The gold standard for assessment of this relationship requires invasive pressure‐volume (PV) loop measurements. Non‐invasive surrogates of RV‐PA coupling have been developed, such as the echocardiographic tricuspid annular plane systolic excursion to pulmonary artery systolic pressure ratio (TAPSE/PASP), but their performance has not been systematically assessed. We sought to assess performance of TAPSE/PASP ratio compared to PV loop‐defined RV‐PA coupling. A systematic search was conducted. Studies were included if PV loop derived RV‐PA coupling metrics were compared to echocardiographic or magnetic resonance imaging surrogates. We conducted a meta‐analysis of TAPSE/PASP correlation to PV loop‐defined RV‐PA coupling. 1452 studies were identified in the initial search, of which ten met inclusion criteria. Five studies allowed for pooled analysis of TAPSE/PASP to Ees/Ea correlation (r = 0.52, 95% confidence interval 0.36–0.65). There was moderate heterogeneity across the pooled studies. Despite the common use of Non‐invasive surrogates of RV‐PA coupling, there is only moderate correlation with gold standard measurements. These metrics do not inform on the individual components of RV‐PA coupling, limiting their use in the management of patients with RV dysfunction.

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Optimizing Hemodynamic Interventricular Interactions in LVAD Recipients

Houston,

Fang

2024

JACC: Heart Failure

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Occult right ventricular dysfunction and right ventricular-vascular uncoupling in left ventricular assist device recipients

Cited by 4 publications

References 38 publications

Biventricular catheterization combined with pressure‐volume loop monitoring provides insight into the dynamic effects of left ventricular assist devices ramp on right ventricular function

Biventricular catheterization combined with pressure‐volume loop monitoring provides insight into the dynamic effects of left ventricular assist devices ramp on right ventricular function

Non‐invasive surrogates for right Ventricular‐Pulmonary arterial coupling: a systematic review and Meta‐Analysis

Optimizing Hemodynamic Interventricular Interactions in LVAD Recipients

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