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Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation
AIMS: Patients awaiting orthotopic heart transplantation (OHT) can be bridged utilizing a left ventricular assist device (LVAD) that reduces left ventricular filling pressures, decreases pulmonary artery wedge pressure, and maintains adequate cardiac output. This study set out to examine the poorly...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065852/ https://www.ncbi.nlm.nih.gov/pubmed/35322594 http://dx.doi.org/10.1002/ehf2.13890 |
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author | Ingvarsson, Annika Gjesdal, Grunde Borgenvik, Saeideh Werther Evaldsson, Anna Waktare, Johan Braun, Oscar Smith, Gustav J. Roijer, Anders Rådegran, Göran Meurling, Carl |
author_facet | Ingvarsson, Annika Gjesdal, Grunde Borgenvik, Saeideh Werther Evaldsson, Anna Waktare, Johan Braun, Oscar Smith, Gustav J. Roijer, Anders Rådegran, Göran Meurling, Carl |
author_sort | Ingvarsson, Annika |
collection | PubMed |
description | AIMS: Patients awaiting orthotopic heart transplantation (OHT) can be bridged utilizing a left ventricular assist device (LVAD) that reduces left ventricular filling pressures, decreases pulmonary artery wedge pressure, and maintains adequate cardiac output. This study set out to examine the poorly investigated area of if and how pre‐treatment with LVAD impacts right ventricular (RV) function following OHT. METHODS AND RESULTS: We prospectively evaluated 59 (LVAD n = 20) consecutive OHT patients. Transthoracic echocardiography (TTE) was performed in conjunction with right heart catheterization (RHC) at 1, 6, and 12 months after OHT. RV function TTE‐parameters included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S′), fractional area change, two‐dimensional RV global longitudinal strain and longitudinal strain from the RV lateral wall (RVfree). At 1 month after OHT, the LVAD group had significantly better longitudinal RV function than the non‐LVAD group: TAPSE (15 ± 3 mm vs. 12 ± 2 mm, P < 0.001), RV global longitudinal strain (−19.8 ± 2.1% vs. −14.3 ± 2.8%, P < 0.001), and RVfree (−19.8 ± 2.3% vs. −14.1 ± 2.9%, P < 0.001). At this time point, pulmonary vascular resistance (PVR) was also lower [1.2 ± 0.4 Wood Units (WU) vs. 1.6 ± 0.6 WU, P < 0.05] in the LVAD group compared with the non‐LVAD group. At 6 and 12 months, no difference was detected in any of the TTE and RHC measured parameters between the two groups. Between 1 and 12 months, all parameters of RV function improved significantly in the non‐LVAD group but remained unaltered in the LVAD group. CONCLUSIONS: Our results indicate that pre‐treatment with LVAD decreases PVR and is associated with significantly better RV function early following OHT. During the first year following transplantation, RV function progressively improved in the non‐LVAD group such that at 6 and 12 months, no difference in RV function was detected between the groups. |
format | Online Article Text |
id | pubmed-9065852 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90658522022-05-04 Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation Ingvarsson, Annika Gjesdal, Grunde Borgenvik, Saeideh Werther Evaldsson, Anna Waktare, Johan Braun, Oscar Smith, Gustav J. Roijer, Anders Rådegran, Göran Meurling, Carl ESC Heart Fail Original Articles AIMS: Patients awaiting orthotopic heart transplantation (OHT) can be bridged utilizing a left ventricular assist device (LVAD) that reduces left ventricular filling pressures, decreases pulmonary artery wedge pressure, and maintains adequate cardiac output. This study set out to examine the poorly investigated area of if and how pre‐treatment with LVAD impacts right ventricular (RV) function following OHT. METHODS AND RESULTS: We prospectively evaluated 59 (LVAD n = 20) consecutive OHT patients. Transthoracic echocardiography (TTE) was performed in conjunction with right heart catheterization (RHC) at 1, 6, and 12 months after OHT. RV function TTE‐parameters included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S′), fractional area change, two‐dimensional RV global longitudinal strain and longitudinal strain from the RV lateral wall (RVfree). At 1 month after OHT, the LVAD group had significantly better longitudinal RV function than the non‐LVAD group: TAPSE (15 ± 3 mm vs. 12 ± 2 mm, P < 0.001), RV global longitudinal strain (−19.8 ± 2.1% vs. −14.3 ± 2.8%, P < 0.001), and RVfree (−19.8 ± 2.3% vs. −14.1 ± 2.9%, P < 0.001). At this time point, pulmonary vascular resistance (PVR) was also lower [1.2 ± 0.4 Wood Units (WU) vs. 1.6 ± 0.6 WU, P < 0.05] in the LVAD group compared with the non‐LVAD group. At 6 and 12 months, no difference was detected in any of the TTE and RHC measured parameters between the two groups. Between 1 and 12 months, all parameters of RV function improved significantly in the non‐LVAD group but remained unaltered in the LVAD group. CONCLUSIONS: Our results indicate that pre‐treatment with LVAD decreases PVR and is associated with significantly better RV function early following OHT. During the first year following transplantation, RV function progressively improved in the non‐LVAD group such that at 6 and 12 months, no difference in RV function was detected between the groups. John Wiley and Sons Inc. 2022-03-23 /pmc/articles/PMC9065852/ /pubmed/35322594 http://dx.doi.org/10.1002/ehf2.13890 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Ingvarsson, Annika Gjesdal, Grunde Borgenvik, Saeideh Werther Evaldsson, Anna Waktare, Johan Braun, Oscar Smith, Gustav J. Roijer, Anders Rådegran, Göran Meurling, Carl Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
title | Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
title_full | Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
title_fullStr | Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
title_full_unstemmed | Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
title_short | Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
title_sort | impact of bridging with left ventricular assist device on right ventricular function following heart transplantation |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065852/ https://www.ncbi.nlm.nih.gov/pubmed/35322594 http://dx.doi.org/10.1002/ehf2.13890 |
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