Benedetto Maria, Piccone Giulia, Nardozi Ludovica, Baca Georgiana Luisa, Baiocchi Massimo
Anaesthesiology and Intensive Care, Cardiothoracic and Vascular Department, IRCSS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, Bologna, Italy.
Laboratory of Cardiovascular Science, National Institute On Aging, NIH, Baltimore, USA.
Indian J Thorac Cardiovasc Surg. 2023 Jul;39(Suppl 1):170-181. doi: 10.1007/s12055-022-01447-7. Epub 2023 Jan 11.
Right ventricular failure (RVF) in patients with a continuous-flow left ventricle assist device (CF-LVAD) is associated with higher incidence of mortality. This systematic review aims to assess the overall proportion of RVF and the pre-operative echocardiographic parameters which are best correlating to RVF.
A systematic research was conducted between 2008 and 2019 on MEDLINE, EMBASE, PUBMED, UPTODATE, OVID, COCHRANE LIBRARY, and Google Scholar electronic databases by performing a PRISMA flowchart. All observational studies regarding echocardiographic predictors of RVF in patients undergoing CF-LVAD implantation were included.
A total number of 19 observational human studies published between 2008 and 2019 were included. We identified 524 RVF patients out of a pooled final population of 1741 patients. The RVF overall proportion was 28.25% with 95% confidence interval (CI) 0.24-0.34. The highest variability of perioperative echocardiographic parameters between the RVF and no right ventricular failure (NO-RVF) groups has been found with tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and right ventricular global longitudinal strain (RVGLS). Their standardized mean deviation (SMD) was - 0.33 (95% CI - 0.54 to - 0.11; value 0.003), - 0.34 (95% CI - 0.53 to - 0.15; value 0.0001), and 0.52 (95% CI 0.79 to 0.25; value 0.0001), respectively.
The echocardiographic predictors of RVF after CF-LVAD placement are still uncertain. However, there seems to be a trend of statistical correlation between TAPSE, FAC, and RVGLS with RVF event after CF-LVAD placement.
The online version contains supplementary material available at 10.1007/s12055-022-01447-7.
接受连续血流左心室辅助装置（CF-LVAD）治疗的患者发生右心室衰竭（RVF）与更高的死亡率相关。本系统评价旨在评估RVF的总体比例以及与RVF最相关的术前超声心动图参数。
通过执行PRISMA流程图，于2008年至2019年在MEDLINE、EMBASE、PUBMED、UPTODATE、OVID、COCHRANE图书馆和谷歌学术电子数据库上进行了系统研究。纳入了所有关于接受CF-LVAD植入患者RVF的超声心动图预测指标的观察性研究。
纳入了2008年至2019年发表的总共19项观察性人体研究。在总共1741例患者的最终汇总人群中，我们识别出524例RVF患者。RVF的总体比例为28.25%，95%置信区间（CI）为0.24 - 0.34。在RVF组和无右心室衰竭（NO-RVF）组之间，三尖瓣环平面收缩期位移（TAPSE）、面积变化分数（FAC）和右心室整体纵向应变（RVGLS）的围手术期超声心动图参数差异最大。它们的标准化平均偏差（SMD）分别为-0.33（95%CI -0.54至-0.11；P值0.003）、-0.34（95%CI -0.53至-0.15；P值0.0001）和0.52（95%CI 0.79至0.25；P值0.0001）。
CF-LVAD植入术后RVF的超声心动图预测指标仍不确定。然而，TAPSE、FAC和RVGLS与CF-LVAD植入术后RVF事件之间似乎存在统计学相关趋势。
在线版本包含可在10.1007/s12055-022-01447-7获取的补充材料。
