Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation
Ingvarsson, Annika LU
; Gjesdal, Grunde
LU
; Borgenvik, Saeideh
; Werther Evaldsson, Anna
LU
; Waktare, Johan
; Braun, Oscar
LU
; Smith, Gustav J
LU
; Roijer, Anders
LU
; Rådegran, Göran
LU
and Meurling, Carl
LU
(2022)
In ESC Heart Failure
9(3).
p.1864-1874
- Abstract
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... (More)
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.
(Less)
- author
- Ingvarsson, Annika
LU
; Gjesdal, Grunde
LU
; Borgenvik, Saeideh
; Werther Evaldsson, Anna
LU
; Waktare, Johan
; Braun, Oscar
LU
; Smith, Gustav J
LU
; Roijer, Anders
LU
; Rådegran, Göran
LU
and Meurling, Carl
LU
- organization
-
- Cardiology
- Heart Failure and Mechanical Support (research group)
- Molecular Epidemiology and Cardiology (research group)
- EXODIAB: Excellence of Diabetes Research in Sweden
- WCMM-Wallenberg Centre for Molecular Medicine
- Cardiovascular Epigenetics (research group)
- EpiHealth: Epidemiology for Health
- Lund Hemodynamic Lab (research group)
- Cardiopulmonary disease - information, support and reception (research group)
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- in
- ESC Heart Failure
- volume
- 9
- issue
- 3
- pages
- 1864 - 1874
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:35322594
- scopus:85126838424
- ISSN
- 2055-5822
- DOI
- 10.1002/ehf2.13890
- language
- English
- LU publication?
- yes
- additional info
- © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
- id
- 100f6050-40ac-4384-b15b-75a9a6951c59
- date added to LUP
- 2022-04-01 06:42:17
- date last changed
- 2024-07-11 14:26:50
@article{100f6050-40ac-4384-b15b-75a9a6951c59,
abstract = {{<p>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.</p><p>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.</p><p>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.</p>}},
author = {{Ingvarsson, Annika and Gjesdal, Grunde and Borgenvik, Saeideh and Werther Evaldsson, Anna and Waktare, Johan and Braun, Oscar and Smith, Gustav J and Roijer, Anders and Rådegran, Göran and Meurling, Carl}},
issn = {{2055-5822}},
language = {{eng}},
number = {{3}},
pages = {{1864--1874}},
publisher = {{John Wiley & Sons Inc.}},
series = {{ESC Heart Failure}},
title = {{Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation}},
url = {{http://dx.doi.org/10.1002/ehf2.13890}},
doi = {{10.1002/ehf2.13890}},
volume = {{9}},
year = {{2022}},
}