Echocardiographic Parameters of Right Ventricular Size and Function Associated With Right Heart Failure After Durable Left Ventricular Assist Device Implantation—A Systematic Review and Meta-Analysis

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-03-04 DOI:10.1111/echo.70119

Jia Cheng Kevyn Chai, Jia Le Chew, Anjalee Amarasekera, Hatem Soliman Aboumarie, Timothy C. Tan

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引用次数: 0

Abstract

Background

Late-onset Right Ventricular (RV) failure is an established complication of Durable Left-Ventricular Assist Device (D-LVAD) implantation. Transthoracic echocardiography (TTE) remains the primary imaging modality for serial monitoring in this population, but its interpretation remains challenging due to device-related changes in RV size and function and a lack of guidelines addressing this impact. This study aims to examine the diagnostic and prognostic utility of TTE parameters of RV size and function in the detection of late-onset RV failure post-implantation.

Methods and Results

A systematic literature search of medical databases was performed to identify all relevant studies assessing TTE parameters in adult patients with D-LVADs (January 2003–August 2023; English only). Of the 350 studies identified, nine studies with a pooled cohort of 627 patients and three studies with a pooled cohort of 175 patients (40 Cases and 135 controls) were meta-analyzed across a range of structural and functional TTE parameters. Compared to World Alliance Societies of Echocardiography (WASE) reference values, this population had dilated RV size (as quantified by RVEDD) and reduced systolic function (as quantified by TAPSE, RVFAC, and RVEF). TAPSE was positively associated with the non-RVF group, while RVEDD was negatively associated with the non-RVF group.

Conclusions

Based on the available studies, there was baseline RV dilatation and reduced systolic function in patients with D-LVADs. Additionally, TAPSE and RVEDD demonstrated a statistically significant association with the development of RVF post-implantation, indicating a potential role as prognostic markers. Further studies should also be conducted to establish post-implantation TTE reference values.

Abstract Image

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持久左心室辅助装置植入后与右心衰相关的右心室大小和功能超声心动图参数-系统回顾和荟萃分析

背景：迟发性右心室（RV）衰竭是持久左心室辅助装置（D-LVAD）植入后的并发症。经胸超声心动图（TTE）仍然是该人群串行监测的主要成像方式，但由于设备相关的心室大小和功能变化以及缺乏针对这种影响的指南，其解释仍然具有挑战性。本研究旨在探讨RV大小和功能的TTE参数在检测晚发性RV植入后失效中的诊断和预后效用。方法和结果对医学数据库进行系统的文献检索，以确定评估成年d - lvad患者TTE参数的所有相关研究(2003年1月- 2023年8月；只说英语)。在确定的350项研究中，9项研究纳入了627例患者的合并队列，3项研究纳入了175例患者的合并队列（40例和135例对照），对TTE的结构和功能参数进行了meta分析。与世界超声心动图协会（WASE）的参考值相比，该人群右心室尺寸扩大（通过RVEDD量化），收缩功能降低（通过TAPSE、RVFAC和RVEF量化）。TAPSE与非裂谷热组呈正相关，而RVEDD与非裂谷热组负相关。根据现有的研究，d - lvad患者存在基线左室扩张和收缩功能降低。此外，TAPSE和RVEDD显示与植入后裂谷热的发展有统计学意义的关联，表明其作为预后标志物的潜在作用。还应进行进一步的研究以确定植入后TTE的参考值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.