TY - JOUR
T1 - The prognostic role of advanced hemodynamic variables in patients with left ventricular assist devices
AU - Kanelidis, Anthony J.
AU - Siddiqi, Umar
AU - Miller, Tamari
AU - Belkin, Mark
AU - Li, George
AU - Smith, Bryan
AU - Kalantari, Sara
AU - Nguyen, Ann
AU - Chung, Ben B.
AU - Sarswat, Nitasha
AU - Kim, Gene
AU - Salerno, Christopher
AU - Jeevanandam, Valluvan
AU - Pinney, Sean
AU - Grinstein, Jonathan
N1 - Publisher Copyright:
© 2022 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.
PY - 2023/3
Y1 - 2023/3
N2 - Background: Invasive hemodynamic variables obtained from right heart catheterization have been used for risk-stratifying patients with advanced heart failure (HF). However, there is a paucity of data on the prognostic value of invasive hemodynamic variables in patients with left ventricular assist devices (LVAD). We hypothesized that cardiac power output (CPO), cardiac power efficiency (CPE), and left ventricular stroke work index (LVSWI) can serve as prognostic markers in patients with LVADs. Methods: Baseline hemodynamic data from patients who had LVAD ramp studies at our institution from 4/2014 to 7/2018 were prospectively collected, from which advanced hemodynamic variables (CPO, CPE, and LVSWI) were retrospectively analyzed. Univariate and multivariable analyses were performed for hemocompatibility-related adverse events (HRAE), HF admissions, and mortality. Results: Ninety-one participants (age 61 ± 11 years, 34% women, 40% Black or African American, and 38% ischemic cardiomyopathy) were analyzed. Low CPE was significantly associated with mortality (HR 2.42, 95% CI 1.02–5.74, p = 0.045) in univariate analysis and Kaplan–Meier analysis (p = 0.04). Low LVSWI was significantly associated with mortality (HR 2.13, 95% CI 1.09–4.17, p = 0.03) in univariate analysis and Kaplan–Meier analysis (p = 0.02). CPO was not associated with mortality. CPO, CPE, and LVSWI were not associated with HRAE or HF admissions. Conclusions: Advanced hemodynamic variables can serve as prognostic indicators for patients with LVADs. Low CPE and LVSWI are prognostic for higher mortality, but no variables were associated with HF admissions or HRAEs.
AB - Background: Invasive hemodynamic variables obtained from right heart catheterization have been used for risk-stratifying patients with advanced heart failure (HF). However, there is a paucity of data on the prognostic value of invasive hemodynamic variables in patients with left ventricular assist devices (LVAD). We hypothesized that cardiac power output (CPO), cardiac power efficiency (CPE), and left ventricular stroke work index (LVSWI) can serve as prognostic markers in patients with LVADs. Methods: Baseline hemodynamic data from patients who had LVAD ramp studies at our institution from 4/2014 to 7/2018 were prospectively collected, from which advanced hemodynamic variables (CPO, CPE, and LVSWI) were retrospectively analyzed. Univariate and multivariable analyses were performed for hemocompatibility-related adverse events (HRAE), HF admissions, and mortality. Results: Ninety-one participants (age 61 ± 11 years, 34% women, 40% Black or African American, and 38% ischemic cardiomyopathy) were analyzed. Low CPE was significantly associated with mortality (HR 2.42, 95% CI 1.02–5.74, p = 0.045) in univariate analysis and Kaplan–Meier analysis (p = 0.04). Low LVSWI was significantly associated with mortality (HR 2.13, 95% CI 1.09–4.17, p = 0.03) in univariate analysis and Kaplan–Meier analysis (p = 0.02). CPO was not associated with mortality. CPO, CPE, and LVSWI were not associated with HRAE or HF admissions. Conclusions: Advanced hemodynamic variables can serve as prognostic indicators for patients with LVADs. Low CPE and LVSWI are prognostic for higher mortality, but no variables were associated with HF admissions or HRAEs.
KW - advanced hemodynamic variables
KW - cardiac power efficiency
KW - cardiac power output
KW - heart failure
KW - left ventricular assist device
KW - left ventricular stroke work index
UR - http://www.scopus.com/inward/record.url?scp=85141879210&partnerID=8YFLogxK
U2 - 10.1111/aor.14441
DO - 10.1111/aor.14441
M3 - Article
C2 - 36305735
AN - SCOPUS:85141879210
SN - 0160-564X
VL - 47
SP - 574
EP - 581
JO - Artificial Organs
JF - Artificial Organs
IS - 3
ER -