title: Preoperative Echocardiography Examination of Right Ventricle Function in Patients Scheduled for LVAD Implantation Correlates with Postoperative Hemodynamic Examinations.
abstract: BACKGROUND Left ventricular assist devices (LVAD) are used to treat heart failure. Preoperative prediction of RV function after LVAD implantation is crucial. Correlations were found between preoperative echo and RV function after LVAD implantation. MATERIAL AND METHODS We retrospectively reviewed 23 male patients (8 ischemic, 15 nonischemic cardiomyopathy) with LVAD implantation (17 HeartWare, 6 HeartMate II) at the Silesian Center for Heart Diseases from 1 January 2013 to 28 October 2014. Preoperative TTE data of RV function included RVFAC (fractional area change), TAPSE (tricuspid annulus plane systolic excursion), RV diameter (RV4), and RV/LV (right/left ventricle) ratio. Postoperative hemodynamic mean pulmonary pressure (mPAP), central venous pressure (CVP), cardiac output (CO), and cardiac index (CI) were measured and recorded every 2 h up to 10 days (1, 2, …120) and correlated. Study endpoints were mortality, discharge from ICU, and RV dysfunction. RESULTS There were no RV dysfunctions. Correlations of CO and CI with RV4 and RV/LV ratio were significantly positive at many time points, with TAPSE and FAC positive or negative. Correlations mPAP with RV4 were significantly positive: 1, 2, 3, 7, 8, 57, 58, 59. With RV/LV ratio positive: 44, 47, with TAPSE in 36. With FAC positive 11, 13-15, 22 and negative 57. Correlations CVP with RV4 were negative, with positive significance in 1, 52. With RV/LV ratio positively 52, 54, 56 and negative 71, 72, 73. With TAPSE were negative significantly: 30, 68. With FAC positive 11, 12, 13, 14 and negative: 68. CONCLUSIONS RV4 and RV/LV ratio before LVAD implantation are more predictive for postoperative RV function than RVFAC and TAPSE, probably because RVFAC and TAPSE are load-dependent.
authors: Department of Cardiac Anaesthesia and Intensive Care, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Paweł
authors: P
authors: Nadziakiewicz
authors: Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Tomasz
authors: T
authors: Niklewski
authors: 3rd Department of Cardiology, Medical University of Silesia, Zabrze, Poland.
authors: Bożena
authors: B
authors: Szyguła-Jurkiewicz
authors: Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Jerzy
authors: J
authors: Pacholewicz
authors: Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Michał
authors: M
authors: Zakliczyński
authors: Department of Cardiac Anaesthesia and Intensive Care, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Jarosław
authors: J
authors: Borkowski
authors: Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Tomasz
authors: T
authors: Hrapkowicz
authors: Department of Cardiac Surgery and Transplantation, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors: Marian
authors: M
authors: Zembala
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D016278:Ventricular Function, Right