Predictors of right ventricular failure in patients after left ventricular assist device implantation
Background. To determine predictors of early and late right ventricular failure (RVF) according to transthoracic echocardiography (TTEchoCG) and right heart catheterisation (RHC) in patients with left ventricular assist device (LVAD). Materials and methods. Twenty-three patients with LVAD were in...
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| Format: | Article |
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"Consilium Medicum" Publishing house
2025-01-01
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| Series: | Терапевтический архив |
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| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/645360/194490 |
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| author | Janna A. Shahramanova Oleg Yu. Narusov Maksim I. Makeev Stanislav M. Smirnov Elena V. Dzybinskaia Kamil G. Ganaev Andrey A. Shiryaev Irina A. Merkulova Dmitry V. Pevzner Marina A. Saidova Sergey N. Tereshchenko |
| author_facet | Janna A. Shahramanova Oleg Yu. Narusov Maksim I. Makeev Stanislav M. Smirnov Elena V. Dzybinskaia Kamil G. Ganaev Andrey A. Shiryaev Irina A. Merkulova Dmitry V. Pevzner Marina A. Saidova Sergey N. Tereshchenko |
| author_sort | Janna A. Shahramanova |
| collection | DOAJ |
| description | Background. To determine predictors of early and late right ventricular failure (RVF) according to transthoracic echocardiography (TTEchoCG) and right heart catheterisation (RHC) in patients with left ventricular assist device (LVAD).
Materials and methods. Twenty-three patients with LVAD were included in the study. Before implantation, all patients underwent TTEchoCG with comprehensive evaluation of the right ventricle (RV) using speckle-tracking echocardiography (STE) and 3D-echocardiography (3D-RVEF), as well as RHC with measurement of standard indices and calculation of pulmonary artery pulsatility index (PAPi).
Results. The highest area under the ROC curve was the RV ejection fraction determined by 3D-RVEF (0.841 with 95% CI 0.677–1.006, sensitivity 0.889, specificity 0.786; p0.001) with a cut-off value ≤42% (OR 29.3 with 95% CI 2.6–336.4; p=0.007) and PAPi (area on ROC curve 0.869 with 95% CI 0.503–0.975, sensitivity 0.778, specificity 0.857; p0.001,) with a threshold value ≤2.2 (OR 20 with 95% CI 1.2–333.3; p=0.035). The combination of these parameters was the most accurate prognostic model (sensitivity 0.778, specificity 1). The combination of echocardiographic parameters – 3D-RVEF and systolic velocity of the tricuspid valve fibrous ring according to tissue myocardial Doppler (TMD: S’ml) has similar sensitivity (0.778) and slightly lower specificity (0.929).
Conclusion. The optimal independent echocardiographic predictor of early RVF is 3D-RVEF. The combination of 3D-RVEF and PAPi proved to be the most accurate model, but the combination of 3D-RVEF and S’ml-TMD echocardiographic parameters alone is only slightly inferior in specificity, which allows preliminary assessment of the risk of RVF. |
| format | Article |
| id | doaj-art-c5662aa9da8141e5a532d523bd3b10c3 |
| institution | Kabale University |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| publishDate | 2025-01-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj-art-c5662aa9da8141e5a532d523bd3b10c32025-08-20T03:47:32Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422025-01-0197432232810.26442/00403660.2025.04.20316978630Predictors of right ventricular failure in patients after left ventricular assist device implantationJanna A. Shahramanova0https://orcid.org/0009-0007-9478-9530Oleg Yu. Narusov1https://orcid.org/0000-0003-2960-0950Maksim I. Makeev2https://orcid.org/0000-0002-4779-5088Stanislav M. Smirnov3https://orcid.org/0000-0003-3570-457XElena V. Dzybinskaia4https://orcid.org/0000-0002-1849-442XKamil G. Ganaev5https://orcid.org/0000-0002-8438-2450Andrey A. Shiryaev6https://orcid.org/0000-0002-3325-9743Irina A. Merkulova7https://orcid.org/0000-0001-7461-3422Dmitry V. Pevzner8https://orcid.org/0000-0002-5290-0065Marina A. Saidova9https://orcid.org/0000-0002-3233-1862Sergey N. Tereshchenko10https://orcid.org/0000-0001-9234-6129Chazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyChazov National Medical Research Center of CardiologyBackground. To determine predictors of early and late right ventricular failure (RVF) according to transthoracic echocardiography (TTEchoCG) and right heart catheterisation (RHC) in patients with left ventricular assist device (LVAD). Materials and methods. Twenty-three patients with LVAD were included in the study. Before implantation, all patients underwent TTEchoCG with comprehensive evaluation of the right ventricle (RV) using speckle-tracking echocardiography (STE) and 3D-echocardiography (3D-RVEF), as well as RHC with measurement of standard indices and calculation of pulmonary artery pulsatility index (PAPi). Results. The highest area under the ROC curve was the RV ejection fraction determined by 3D-RVEF (0.841 with 95% CI 0.677–1.006, sensitivity 0.889, specificity 0.786; p0.001) with a cut-off value ≤42% (OR 29.3 with 95% CI 2.6–336.4; p=0.007) and PAPi (area on ROC curve 0.869 with 95% CI 0.503–0.975, sensitivity 0.778, specificity 0.857; p0.001,) with a threshold value ≤2.2 (OR 20 with 95% CI 1.2–333.3; p=0.035). The combination of these parameters was the most accurate prognostic model (sensitivity 0.778, specificity 1). The combination of echocardiographic parameters – 3D-RVEF and systolic velocity of the tricuspid valve fibrous ring according to tissue myocardial Doppler (TMD: S’ml) has similar sensitivity (0.778) and slightly lower specificity (0.929). Conclusion. The optimal independent echocardiographic predictor of early RVF is 3D-RVEF. The combination of 3D-RVEF and PAPi proved to be the most accurate model, but the combination of 3D-RVEF and S’ml-TMD echocardiographic parameters alone is only slightly inferior in specificity, which allows preliminary assessment of the risk of RVF.https://ter-arkhiv.ru/0040-3660/article/viewFile/645360/194490lvadartificial left ventriclemechanical circulatory supportright ventricular failure |
| spellingShingle | Janna A. Shahramanova Oleg Yu. Narusov Maksim I. Makeev Stanislav M. Smirnov Elena V. Dzybinskaia Kamil G. Ganaev Andrey A. Shiryaev Irina A. Merkulova Dmitry V. Pevzner Marina A. Saidova Sergey N. Tereshchenko Predictors of right ventricular failure in patients after left ventricular assist device implantation Терапевтический архив lvad artificial left ventricle mechanical circulatory support right ventricular failure |
| title | Predictors of right ventricular failure in patients after left ventricular assist device implantation |
| title_full | Predictors of right ventricular failure in patients after left ventricular assist device implantation |
| title_fullStr | Predictors of right ventricular failure in patients after left ventricular assist device implantation |
| title_full_unstemmed | Predictors of right ventricular failure in patients after left ventricular assist device implantation |
| title_short | Predictors of right ventricular failure in patients after left ventricular assist device implantation |
| title_sort | predictors of right ventricular failure in patients after left ventricular assist device implantation |
| topic | lvad artificial left ventricle mechanical circulatory support right ventricular failure |
| url | https://ter-arkhiv.ru/0040-3660/article/viewFile/645360/194490 |
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