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March 31, 2017European Journal of Heart Failure

The meta-analysed prevalence of post-LVAD RVF was 35%, with the need for continuous renal replacement therapy (OR 4.61) and mechanical ventilation (OR 2.99) being the strongest clinical predictors.

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Why the study?

What are the strongest clinical, biochemical, haemodynamic, and echocardiographic predictors of right ventricular failure after LVAD implantation?

Population

4,428 patients undergoing left ventricular assist device implantation pooled from 36 observational studies

Comparison

Presence of clinical, biochemical, haemodynamic… vs Absence of these risk factors (No-RVF populations)

Design

Meta-analysis

Authors

DBDiego BellaviaAIAttilio IacovoniCSCesare Scardulla

Discussion

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Overview

Pre-LVAD CRRT or mechanical ventilation identifies highest post-LVAD RVF risk; confirms strongest predictors for refined risk models.

Structured PICO

What are the strongest clinical, biochemical, haemodynamic, and echocardiographic predictors of right ventricular failure after LVAD implantation?

P
Population
4,428 patients undergoing left ventricular assist device (LVAD) implantation pooled from 36 observational studies
I
Intervention
Presence of clinical, biochemical, haemodynamic, and echocardiographic risk factors (e.g., mechanical ventilation, CRRT, elevated INR, NT-proBNP, CVP, low RVSWI, RV dysfunction)
C
Comparator
Absence of these risk factors (No-RVF populations)
O
Outcome
Right ventricular failure (RVF) after LVAD implantationhard clinical

Patients requiring ventilatory support or CRRT, as well as those with elevated CVP, low RVSWI, and pre-implant RV dysfunction, are at high risk for right ventricular failure following LVAD implantation.

Cite This Study

Bellavia et al. (2017) studied this question.

synapsesocial.com/papers/69df8b42915fa04953614de3https://doi.org/10.1002/ejhf.733
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