Nuqali Abdulelah, Dalia Tarun, McKinley Grant, Tayeb Taher, Hu Jinxiang, Mei Xiaohang, Rosamond Thomas, Shah Zubair
Queen's Heart Institute, The Queen's Medical Center, Honolulu, Hawaii.
Department of Cardiovascular Medicine, The University of Kansas Health System, Kansas City, Kansas.
JHLT Open. 2024 Jan 15;4:100056. doi: 10.1016/j.jhlto.2024.100056. eCollection 2024 May.
Despite the advancement in the left ventricular assist devices (LVADs), right heart failure (RHF) remains a challenging adverse event after LVAD implantation and is associated with increased morbidity and mortality. In this study, we sought to assess the role of cardiac magnetic resonance-derived right ventricular ejection fraction (CMR-RVEF) in predicting the risk of post-LVAD RHF. Overall baseline characteristics and clinical outcomes were compared between the patients who developed post-LVAD RHF and those who did not. A total of 42 patients who underwent CMR before LVAD implantation were included in this study. The mean CMR-RVEF was 25 ± 13%, with no statistically significant difference between the 2 groups (27.7 ± 13.9% vs 24.5 ± 12.3, = 0.5). The mean of the CMR-derived right ventricular volume index trend was higher in those with post-LVAD RHF (76 ± 28 ml/m vs 65 ± 25 ml/m; = 0.31). In conclusion, in patients who underwent CMR before LVAD implantation, CMR-RVEF may not predict post-LVAD RHF. Large multicenter studies are needed to confirm this finding.
尽管左心室辅助装置(LVADs)取得了进展,但右心衰竭(RHF)仍然是LVAD植入后具有挑战性的不良事件,并且与发病率和死亡率增加相关。在本研究中,我们试图评估心脏磁共振衍生的右心室射血分数(CMR-RVEF)在预测LVAD植入后发生RHF风险中的作用。比较了发生LVAD植入后RHF的患者和未发生该情况的患者的总体基线特征和临床结局。本研究纳入了42例在LVAD植入前接受心脏磁共振检查的患者。CMR-RVEF的平均值为25±13%,两组之间无统计学显著差异(27.7±13.9%对24.5±12.3,P = 0.5)。LVAD植入后发生RHF的患者中,CMR衍生的右心室容积指数趋势的平均值更高(76±28 ml/m对65±25 ml/m;P = 0.31)。总之,在LVAD植入前接受心脏磁共振检查的患者中,CMR-RVEF可能无法预测LVAD植入后发生的RHF。需要大型多中心研究来证实这一发现。