Longitudinal Trajectories of Hemodynamics Following Left Ventricular Assist Device Implantation: Hemodynamic trends in LVAD patients

Takeo Fujino, Aline Sayer, Daisuke Nitta, Teruhiko Imamura, Nikhil Narang, Ann Nguyen, Daniel Rodgers, Jayant Raikhelkar, Bryan Smith, Gene Kim, Colleen LaBuhn, Valluvan Jeevanandam, Daniel Burkhoff, Gabriel Sayer, Nir Uriel

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: Continuous-flow left ventricular assist devices (LVADs) improve the hemodynamics of patients with advanced heart failure. However, the longitudinal trajectories of hemodynamics in patients after LVAD implantation remain unknown. The aim of this study was to investigate the trends of hemodynamic parameters following LVAD implantation. Methods and Results: We retrospectively reviewed patients who underwent LVAD implantation between April 2014 and August 2018. We collected hemodynamic parameters from right heart catheterizations. Of 199 consecutive patients, we enrolled 150 patients who had both pre- and postimplant right heart catheterizations. They had 3 (2, 4) postimplant right heart catheterizations during a follow-up of 2.3 (1.3, 3.1) years. The mean age was 57 ± 13 years, and 102 patients (68%) were male. Following LVAD implantation, pulmonary arterial pressure and pulmonary capillary wedge pressure decreased, and cardiac index increased significantly, then remained unchanged throughout follow-up. Right atrial pressure decreased initially and then gradually increased to preimplant values. The pulmonary artery pulsatility index decreased initially and returned to preimplant values, then progressively decreased over longer follow-up. Subgroup analysis showed significant differences in the trajectories of the pulmonary artery pulsatility index based on gender. Conclusions: Despite improvement in left-side filling pressures and cardiac index following LVAD implantation, right atrial pressure increased and the pulmonary artery pulsatility index decreased over time, suggesting progressive right ventricular dysfunction.

Original languageEnglish
Pages (from-to)383-390
Number of pages8
JournalJournal of Cardiac Failure
Volume26
Issue number5
DOIs
Publication statusPublished - May 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Longitudinal Trajectories of Hemodynamics Following Left Ventricular Assist Device Implantation: Hemodynamic trends in LVAD patients'. Together they form a unique fingerprint.

Cite this