Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation
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...
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| Format: | Article |
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Wiley
2022-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13890 |
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| author | Annika Ingvarsson Grunde Gjesdal Saeideh Borgenvik Anna Werther Evaldsson Johan Waktare Oscar Braun Gustav J. Smith Anders Roijer Göran Rådegran Carl Meurling |
| author_facet | Annika Ingvarsson Grunde Gjesdal Saeideh Borgenvik Anna Werther Evaldsson Johan Waktare Oscar Braun Gustav J. Smith Anders Roijer Göran Rådegran Carl Meurling |
| author_sort | Annika Ingvarsson |
| collection | DOAJ |
| description | 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 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 | Article |
| id | doaj-art-725db86ec02f4dc6bd757b60af2e078c |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-725db86ec02f4dc6bd757b60af2e078c2025-02-05T05:22:10ZengWileyESC Heart Failure2055-58222022-06-01931864187410.1002/ehf2.13890Impact of bridging with left ventricular assist device on right ventricular function following heart transplantationAnnika Ingvarsson0Grunde Gjesdal1Saeideh Borgenvik2Anna Werther Evaldsson3Johan Waktare4Oscar Braun5Gustav J. Smith6Anders Roijer7Göran Rådegran8Carl Meurling9Department of Clinical Sciences Lund, Cardiology Lund University Lund SwedenDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenThe Section for Heart Failure and Valvular Disease, VO Heart and Lung Medicine Skane University Hospital Entrégatan 7 Lund 221 85 SwedenDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenLiverpool Heart and Chest Hospital Liverpool UKDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenDepartment of Clinical Sciences Lund, Cardiology Lund University Lund SwedenAbstract 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.https://doi.org/10.1002/ehf2.13890Two‐dimensional echocardiographyEarly follow upStrainHeart transplantationRight heart catheterizationLeft ventricular assist device |
| spellingShingle | Annika Ingvarsson Grunde Gjesdal Saeideh Borgenvik Anna Werther Evaldsson Johan Waktare Oscar Braun Gustav J. Smith Anders Roijer Göran Rådegran Carl Meurling Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation ESC Heart Failure Two‐dimensional echocardiography Early follow up Strain Heart transplantation Right heart catheterization Left ventricular assist device |
| 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 | Two‐dimensional echocardiography Early follow up Strain Heart transplantation Right heart catheterization Left ventricular assist device |
| url | https://doi.org/10.1002/ehf2.13890 |
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