Noninvasive Assessment of Hemodynamic Status in HeartWare Left Ventricular Assist Device Patients: Validation of an Echocardiographic Approach

The aim of this prospective study was to validate an echocardiographic protocol derived from 5 HeartWare left ventricular assist device (HVAD) patients for the noninvasive evaluation of right atrial pressure (RAP) and left atrial pressure (LAP) in HVAD patients. Echocardiography is an invaluable too...

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Bibliographic Details
Published in:JACC. Cardiovascular imaging 2019-07, Vol.12 (7 Pt 1), p.1121-1131
Main Authors: Frea, Simone, Centofanti, Paolo, Pidello, Stefano, Giordana, Francesca, Bovolo, Virginia, Baronetto, Andrea, Franco, Beatrice, Cingolani, Marco Matteo, Attisani, Matteo, Morello, Mara, Bergerone, Serena, Rinaldi, Mauro, Gaita, Fiorenzo
Format: Article
Language:English
Subjects:
Aged
Atrial Function, Left
Atrial Function, Right
Atrial Pressure
Cardiac Catheterization
Echocardiography, Doppler, Color
Echocardiography, Doppler, Pulsed
Female
Heart Failure - diagnostic imaging
Heart Failure - physiopathology
Heart Failure - therapy
Heart Valve Prosthesis
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Prosthesis Design
Prosthesis Implantation - adverse effects
Prosthesis Implantation - instrumentation
Recovery of Function
Reproducibility of Results
Risk Factors
Treatment Outcome
Ventricular Function, Left
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Summary:The aim of this prospective study was to validate an echocardiographic protocol derived from 5 HeartWare left ventricular assist device (HVAD) patients for the noninvasive evaluation of right atrial pressure (RAP) and left atrial pressure (LAP) in HVAD patients. Echocardiography is an invaluable tool to optimize medical treatment and pump settings and also for troubleshooting residual heart failure. Little is known about the echocardiographic evaluation of hemodynamic status in HVAD patients. Right heart catheterization and Doppler echocardiography were performed in 35 HVAD patients. Echocardiography-estimated RAP (eRAP) was assessed using inferior vena cava diameter, hepatic venous flow analysis, and tricuspid E/e' ratio. Echocardiography-estimated LAP was assessed using E/A ratio, mitral E/e' ratio, and deceleration time. eRAP and estimated LAP significantly correlated with invasive RAP and LAP (respectively, r = 0.839, p 
ISSN:1876-7591
DOI:10.1016/j.jcmg.2018.01.026