In:
ASAIO Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 63, No. 3 ( 2017-05), p. 266-272
Abstract:
Optimal left ventricular assist device (LVAD) functioning and preservation of right ventricular (RV) function are major survival determinants in destination therapy (DT)-LVAD recipients. Currently, the indication for routine pump speed optimization in stable patients and its effect on RV function at follow-up remain underexplored. Hemodynamically stable patients (N = 17, age 61 [interquartile range {IQR} 51–66] years; 13 [77%] male) underwent a routine speed ramp test. Echocardiographic images were obtained at incremental speed settings to determine optimal pump speed. In 8 patients (47%), LVAD speed could be optimized. In these patients, RV fractional area change (26% [IQR 23–31] to 35% [IQR 27–45] , p = 0.04) and RV longitudinal peak systolic strain (−13% [IQR −16 to −9] to −17% [IQR −18 to −11] , p = 0.02) at 3 months follow-up improved without RV dilatation. Furthermore, N-terminal pro-brain natriuretic peptide level decreased (3,162 [IQR 1,336–4,487] ng/L to 2,294 [IQR 1,157–3,810] ng/L, p = 0.02). No significant follow-up changes were found in patients without indication for speed adjustment. In conclusion, routine evaluation of optimal LVAD speed reveals the potential of speed optimization in a substantial proportion of stable LVAD-DT patients and can improve RV function.
Type of Medium:
Online Resource
ISSN:
1058-2916
DOI:
10.1097/MAT.0000000000000483
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2017
detail.hit.zdb_id:
2083312-X
