Heart failure etiology and risk of right heart failure in adult left ventricular assist device support: the European Registry for Patients with Mechanical Circulatory Support (EUROMACS)

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Brian Bridal Løgstrup
  • Petr Nemec, Centre for Cardiovascular Surgery and Transplantation
  • ,
  • Felix Schoenrath, German Heart Institute, Berlin, German Centre for Cardiovascular Research
  • ,
  • Jan Gummert, Ruhr Univ Bochum, Ruhr University Bochum, MHRTC
  • ,
  • Yuri Pya, National Research Center for Cardiac Surgery
  • ,
  • Evgenij Potapov, German Heart Institute, Berlin
  • ,
  • Ivan Netuka, Institute for Clinical and Experimental Medicine
  • ,
  • Faiz Ramjankhan, University Medical Center Utrecht
  • ,
  • Eric Thorlund Parner
  • Theo De By, EUROMACS, European Registry for Patients with Mechanical Circulatory Support
  • ,
  • Hans Eiskjaer

Objectives: Development of right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation remains a leading cause of perioperative morbidity, end-organ dysfunction and mortality. The objective of this study was to investigate whether the etiology of HF (ischemic HF versus non-ischemic HF) affects the risk of RVF within admission for LVAD implantation and during long-term follow-up. Methods: Between January 2011 and June 27, 2018, 3536 patients were prospectively enrolled into EUROMACS registry. Adult patients (>18 years) who received a first time LVAD were included. When excluding patients with congenital, restrictive, hypertrophic, valvular cardiomyopathies, and myocarditis the total population consisted of 2404 patients. Results: The total cohort consists of 2404 patients. Mean age were 55 years and predominantly male sex [2024 (84.2%)]. At the time of LVAD implantation 1355 (56.4%) patients had ischemic HF and 1049 (43.6%) patients had non-ischemic HF. The incidence of RVF was significantly increased in the non-ischemic HF group in the adjusted model (p = .026). The relative risk difference for RVF in patients with non-ischemic HF was in the adjusted model increased by an absolute value of 5.1% (95% CI: 0.61-9.6). In the ischemic HF group 76 patients (13.4%) developed late RVF and 62 patients (14.8%) in the non-ischemic HF group (p = .56). No differences in occurrence of RVF between HF etiology was observed after 2 and 4 years of follow-up, respectively (crude: p = .25, adjusted (sex and age) p = .2 and crude: p = .59, adjusted (sex and age) p = .44). Conclusions: Patients with non-ischemic HF undergoing LVAD had an increased incidence of early RVF compared to patients with ischemic HF in a large European population. During follow-up after discharge 14% patients developed RVF. We recommend HF etiology to be considered in identifying patients who are at risk for postoperative RVF after LVAD implantation.

OriginalsprogEngelsk
TidsskriftScandinavian Cardiovascular Journal
Vol/bind54
Nummer5
Sider (fra-til)306-314
Antal sider9
ISSN1401-7431
DOI
StatusUdgivet - 2020

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