Right ventricular systolic and diastolic function as assessed by speckle-tracking echocardiography improve with prolonged isolated left ventricular assist device support.
BACKGROUND
Right ventricular (RV) failure is a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Whether RV function deteriorates with prolonged LVAD support is unknown. Speckle-tracking echocardiography provides a sensitive, noninvasive, reproducible, and quantitative assessment of RV systolic and diastolic function.


METHODS
Echocardiograms were retrospectively reviewed from before and after implantation of a Heartmate II LVAD. Speckle-tracking analysis was performed to measure RV longitudinal systolic strain, strain rate, and diastolic strain rate for each patient at baseline and over discrete time periods after LVAD implantation.


RESULTS
Seventeen patients were included in the analysis, with an average follow-up after LVAD implantation of 234 ± 125 days. RV systolic strain improved in 15 patients, decreasing from -7.4 ± 2.3% to -9.7 ± 3.3% after LVAD (P = .026). Systolic strain rate improved in 11 patients, decreasing from -0.67 ± 0.25%/s to -0.96 ± 0.36%/s (P = .011). RV diastolic strain rate improved in 12 patients, increasing from 0.70 ± 0.33%/s to 1.02 ± 0.40%/s (P = .016).


CONCLUSIONS
Chronic LVAD support improves RV systolic and diastolic function in LVAD patients who did not require an RV assist device. Speckle-tracking echocardiography may offer a noninvasive technique for identifying and monitoring improvements in RV function in LVAD patients.
Division of Cardiology, University of Colorado, Aurora, Colorado.
Jerrell W
JW
Herod
Division of Cardiology, University of Colorado, Aurora, Colorado. Electronic address: Amrut.Ambardekar@ucdenver.edu.
Amrut V
AV
Ambardekar
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology; D004452:Echocardiography / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006353:Heart-Assist Devices / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013599:Systole / Q000502:physiology; D013997:Time Factors; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000628:therapy*; D016278:Ventricular Function, Right / Q000502:physiology*
Mechanical circulatory support; heart failure; myocardial recovery; ventricular remodeling