Assessment of Right Ventricular Function in Left Ventricular Assist Device Candidates

• Type of Material: Article
• Authors: Salim Hayek, Emory University; Daniel Sims, Emory University; David Markham, Emory University; Javed Butler, Emory University; Andreas Kalogeropoulos, Emory University
• Language: English
• Date: 2014-03-01
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 American Heart Association, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1161/CIRCIMAGING.113.001127
• Title of Journal or Parent Work: Circulation: Cardiovascular Imaging
• ISSN: 1941-9651
• Volume: 7
• Issue: 2
• Start Page: 379
• End Page: 389
• Grant/Funding Information: This work has been partially supported by (1) the Emory University Research Committee and the Atlanta Clinical & Translational Science Institute (PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources) and (2) an American Heart Association Scientist Development Grant (13SDG15960001)
• Keywords: IMPLANTATION; PATIENT SELECTION; ADVANCED HEART-FAILURE; echocardiography; Life Sciences & Biomedicine; Cardiovascular System & Cardiology; decision support techniques; ECHOCARDIOGRAPHY; Science & Technology; Cardiac & Cardiovascular Systems; MECHANICAL CIRCULATORY SUPPORT; right ventricle; PREDICTORS; heart-assist devices; RECIPIENTS; Radiology, Nuclear Medicine & Medical Imaging; ventricular-assist device; FIXED PULMONARY-HYPERTENSION; RISK-FACTORS; DIAMETER RATIO; heart failure
• Research Categories: Health Sciences, General

Abstract

As a result of the improved survival of patients with heart failure (HF) and the overall rise in the prevalence of HF,1 the number of patients in advanced (stage D) HF continues to increase, thus exceeding the limited availability of donor organs by a wide margin.2 Initially used primarily as a bridge to heart transplantation, mechanical circulatory support is now increasingly offered as a destination therapy to patients with advanced HF in clinical deterioration who are not candidates for transplantation. Improvement in survival to 80% at 1-year postimplantation3 has steadily followed the development of new technologies such as the continuous-flow pump, which now encompasses 99% of left ventricular assist devices (LVADs),3 and improvements in patient and device management. Far from being a panacea, mechanical circulatory support is still fraught with challenges. Among them, post-LVAD right ventricular failure (RVF) is a major cause of morbidity and mortality.