title: Changes in right ventricular function during continuous-flow left ventricular assist device support [corrected].
abstract: BACKGROUND
  Studies in explanted hearts from patients supported with a left ventricular assist device (LVAD) suggest that no or a less pronounced reverse remodeling process occurs in the right ventricle (RV) during LVAD support. The intermediate-term functional changes in RV function in patients with refractory heart failure (HF) supported with a continuous LVAD are not well characterized.
  
  
  METHODS
  Serial transthoracic echocardiograms and simultaneous measurements of biochemical surrogates of disease severity and organ perfusion were obtained in 20 patients (aged 57 +/- 17 years) with refractory HF before and after implantation of a continuous-flow LVAD (VentrAssist, Ventracor Ltd, Chatswood, Australia).
  
  
  RESULTS
  After a median (interquartile range) follow-up of 140 days (34-367 days), RV diameter was reduced (36 +/- 7 vs 33 +/- 4 mm; p = 0.04), as was right atrial area (27 +/- 5 vs 24 +/- 6 cm(2); p = .04). There was a trend toward a reduction in tricuspid annulus plane systolic excursion (14 +/- 6 vs 13 +/- 5 mm; p = .05). RV fractional area change (26% +/- 13% vs 27% +/- 10%; p = .53) and global RV dysfunction graded visually using a scale from 0 (absent) to 3 (severe dysfunction) did not change from pre-implant to follow-up (2 [1-2] vs 1.5 [0.5-2]; p = .18). The degree of global RV dysfunction at follow-up was closely related to the degree of RV dysfunction at the pre-implant study (r = 0.69; p = .001). Changes in global RV dysfunction were inversely related to changes in glomerular filtration rate (r = -0.49; p = .03).
  
  
  CONCLUSIONS
  During continuous-flow LVAD support, pre-existing RV dysfunction does not worsen in the intermediate term.
authors.affiliation: Heart Failure Research Group, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Micha T
authors.initials: MT
authors.lastname: Maeder
authors.forename: Angeline
authors.initials: A
authors.lastname: Leet
authors.forename: Andrew
authors.initials: A
authors.lastname: Ross
authors.forename: Donald
authors.initials: D
authors.lastname: Esmore
authors.forename: David M
authors.initials: DM
authors.lastname: Kaye