Highlights
- •Right ventricular failure remains a significant source of morbidity and mortality
- •Pulmonary artery to aorta ratio is associated with severe right ventricular failure
- •Pulmonary artery to aorta ratio may predict 1-year mortality post LVAD implantation
Abstract
Objectives
To evaluate the association of pulmonary artery diameter and pulmonary artery to aorta
diameter ratio (PA/Ao) with right ventricular failure and mortality within 1 year
after left ventricular assist device implantation.
Design
Retrospective observational study between March 2013 and July 2019.
Setting
Single center, quaternary care academic center.
Participants
Adults (≥ 18 years old) receiving a durable LVAD. Inclusion if 1) a chest CT scan
was performed within 30 days before the LVAD and 2) a right and left heart catheterization
was completed within 30 days before the LVAD.
Interventions
Left Ventricular Assist Device.
Measurements
Total of 176 patients were included in this study. Median PA diameter and PA/Ao ratio
were significantly greater in the severe RVF group (p = 0.001, p < 0.001 respectively).
ROC analysis revealed PA/Ao and RVF as predictors for mortality (area under the curve
0.725, 0.933 respectively). Logistic regression analysis predicted probability gave
a PA/Ao ratio cutoff point of 1.04 (p < 0.001). Survival probability was significantly worse in patients with a PA/Ao ratio ≥ 1.04
(p=0.005).
Conclusions
PA/Ao ratio is an easily measurable noninvasive indicator that can be used as a predictor
of RVF and 1-year mortality post LVAD implantation.
Graphical Abstract
Graphical Abstract
Keywords
Glossary of Abbreviations:
LVAD (left ventricular assist devices), RVF (right ventricular failure), PA (pulmonary artery), PA/Ao (pulmonary artery to aorta ratio), INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support), RHC (Right heart catheterization), PCWP (Pulmonary capillary wedge pressure), SV (stroke volume), CO (cardiac output), CVP (central venous pressure), sPAP (systolic pulmonary artery pressure), dPAP (diastolic pulmonary artery pressure), mPAP (mean pulmonary artery pressure), PVR (pulmonary vascular resistance), TPG (transpulmonary gradient), dTPG (diastolic transpulmonary gradient), PAPi (pulmonary artery pulsatility index), RVSWI (right ventricle stroke work index), PEAS (pulmonary elastance), CVP/PCWP (central venous pressure/ pulmonary capillary wedge pressure ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Published by Elsevier Inc.
