title: Evaluation of Right Ventricular Function in the Management of Patients Referred for Left Ventricular Assist Device Therapy.
abstract: BACKGROUND
  Speckle tracking echocardiography analysis (STE) has recently allowed an in-depth analysis of right ventricular (RV) performance. The aim of the study was to observe RV function by STE in patients with advanced heart failure before and after left ventricular assist device (LVAD) implantation.
  
  
  METHODS
  A transthoracic echocardiogram was performed in 19 patients referred for LVAD implant at baseline and with serial echocardiograms after LVAD implantation (Jarvik 2000). All echocardiographic images were analyzed off line by an independent operator to calculate with STE the RV free wall longitudinal strain (RVLS).
  
  
  RESULTS
  All the patients, except 4, showed a progressive increase of RVLS after LVAD implant. However, 4 patients, who presented the lowest RVLS values at baseline, presented a further RV failure in the postoperative. The value of -11% represented the empirical preoperative cutoff able to identify patients at greater risk of postimplant RV failure.
  
  
  CONCLUSIONS
  RV myocardial deformation may have important clinical implications for the selection and management of LVAD patients. It can be used to evaluate RV function before LVAD implantation, to drive decisional strategy regarding the management of this type of patients, and after LVAD implant for the follow-up.
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy. Electronic address: cameli@cheapnet.it.
authors.forename: M
authors.initials: M
authors.lastname: Cameli
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sparla
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Focardi
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: F M
authors.initials: FM
authors.lastname: Righini
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Solari
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Alvino
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Lisi
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: D'Ascenzi
authors.affiliation: Department of Cardiac Surgery, University of Siena, Siena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bernazzali
authors.affiliation: Department of Cardiac Surgery, University of Siena, Siena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tsioulpas
authors.affiliation: Department of Cardiac Surgery, University of Siena, Siena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Sassi
authors.affiliation: Department of Cardiac Surgery, University of Siena, Siena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Dokollari
authors.affiliation: Department of Cardiac Surgery, University of Siena, Siena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sani
authors.affiliation: Department of Cardiac Surgery, University of Siena, Siena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Maccherini
authors.affiliation: Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Mondillo
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography / Q000009:adverse effects / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*