Comparative Analysis of Established Risk Scores and Novel Hemodynamic Metrics in Predicting Right Ventricular Failure in Left Ventricular Assist Device Patients

Journal of Cardiac Failure
Anthony E PetersSula Mazimba

Abstract

Right ventricular failure (RVF) portends poor outcomes after left ventricular assist device (LVAD) implantation. Although numerous RVF predictive models have been developed, there are few independent comparative analyses of these risk models. RVF was defined as use of inotropes for >14 days, inhaled pulmonary vasodilators for >48 hours or unplanned right ventricular mechanical support postoperatively during the index hospitalization. Risk models were evaluated for the primary outcome of RVF by means of logistic regression and receiver operating characteristic curves. Among 93 LVAD patients with complete data from 2011 to 2016, the Michigan RVF score (C = 0.74 [95% CI 0.61-0.87]; P = .0004) was the only risk model to demonstrate significant discrimination for RVF, compared with newer risk scores (Utah, Pitt, EuroMACS). Among individual hemodynamic/echocardiographic metrics, preoperative right ventricular dysfunction (C = 0.72 [95% CI 0.58-0.85]; P = .0022) also demonstrated significant discrimination of RVF. The Michigan RVF score was also the best predictor of in-hospital mortality (C = 0.67 [95% CI 0.52-0.83]; P = .0319) and 3-year survival (Kaplan-Meier log-rank 0.0135). In external validation analysis, the more established M...Continue Reading

Citations

Nov 30, 2019·European Journal of Heart Failure·Evgenij V PotapovVolkmar Falk
Mar 6, 2021·Pediatric Transplantation·Sabrina P LawUNKNOWN ACTION Learning Network
Aug 11, 2021·Scientific Reports·Hirak ShahRebecca Cogswell
Aug 29, 2021·European Heart Journal. Acute Cardiovascular Care·Gaurav Gulati, Michael S Kiernan
Oct 25, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Hua LiuYong G Peng

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