TY - JOUR
T1 - Deep Y-Descent in Right Atrial Waveforms Following Left Ventricular Assist Device Implantation
T2 - Deep Y-Descent in LVAD
AU - Imamura, Teruhiko
AU - Nitta, Daisuke
AU - Fujino, Takeo
AU - Smith, Bryan
AU - Kalantari, Sara
AU - Nguyen, Ann
AU - Narang, Nikhil
AU - Holzhauser, Luise
AU - Rodgers, Daniel
AU - Song, Tae
AU - Ota, Takeyoshi
AU - Jeevanandam, Valluvan
AU - Kim, Gene
AU - Sayer, Gabriel
AU - Uriel, Nir
N1 - Funding Information:
Funding: This work was supported in part by a Postdoctoral Fellowship for Research Abroad of Japan Society for the Promotion of Science to T.I., and grant support from Abbott and Medtronic to N.U.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/4
Y1 - 2020/4
N2 - Background: Characterization of right heart catheterization (RHC) waveforms provides diagnostic and clinical information in heart failure patients. We aimed to investigate the implication of RHC waveforms, specifically the y-descent, in patients with left ventricular assist device (LVAD). Methods and Results: Patients underwent RHC and waveforms were quantified prior to and 6 months after LVAD implantation. The impact of a deep y-descent (>3 mmHg) on echocardiographic measures of right heart function and 1-year hemocompatibility-related adverse event rates were investigated. Eighty-nine patients (median 59 years old, 65 male) underwent RHC. RHC waveform showed unique changes following LVAD implantation, particularly an increase in the steepness of the y-descent. A post-LVAD deep y-descent was associated with reduced right ventricular function and enlarged right heart. Patients with post-LVAD deep y-descent had higher rates of gastrointestinal bleeding (0.866 vs 0.191 events/year) and stroke (0.199 vs 0 events/year) compared with those without (P<. 05 for both). Conclusion: RHC waveforms characterized by deep y-descent on RHC waveform during LVAD support was associated with impaired right ventricular function and worse clinical outcomes.
AB - Background: Characterization of right heart catheterization (RHC) waveforms provides diagnostic and clinical information in heart failure patients. We aimed to investigate the implication of RHC waveforms, specifically the y-descent, in patients with left ventricular assist device (LVAD). Methods and Results: Patients underwent RHC and waveforms were quantified prior to and 6 months after LVAD implantation. The impact of a deep y-descent (>3 mmHg) on echocardiographic measures of right heart function and 1-year hemocompatibility-related adverse event rates were investigated. Eighty-nine patients (median 59 years old, 65 male) underwent RHC. RHC waveform showed unique changes following LVAD implantation, particularly an increase in the steepness of the y-descent. A post-LVAD deep y-descent was associated with reduced right ventricular function and enlarged right heart. Patients with post-LVAD deep y-descent had higher rates of gastrointestinal bleeding (0.866 vs 0.191 events/year) and stroke (0.199 vs 0 events/year) compared with those without (P<. 05 for both). Conclusion: RHC waveforms characterized by deep y-descent on RHC waveform during LVAD support was associated with impaired right ventricular function and worse clinical outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85079172982&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85079172982&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2020.01.004
DO - 10.1016/j.cardfail.2020.01.004
M3 - Article
C2 - 31935459
AN - SCOPUS:85079172982
SN - 1071-9164
VL - 26
SP - 360
EP - 367
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 4
ER -