Key result
Pathogenic genetic variants linked to ~7-fold higher risk of early post-LVAD right ventricular failure.
Why the study?
Right ventricular failure remains a major complication after LVAD implantation, and current risk models are limited.
Does the presence of pathogenic or likely pathogenic genetic variants increase the risk of early right ventricular failure in patients undergoing LVAD implantation?
Cohort (n=136)
No
Does the presence of pathogenic or likely pathogenic genetic variants increase the risk of early right ventricular failure in patients undergoing LVAD implantation?
Clinically actionable genetic variants are associated with a significantly higher risk of early right ventricular failure following LVAD implantation, suggesting genetic testing could improve perioperative risk stratification.
May support genetic testing to stratify early RV failure risk post-LVAD; hypothesis-generating and requires prospective validation before practice change.
Background: Left ventricular assist device (LVAD) implantation is a life-saving therapy for end-stage heart failure, but right ventricular failure (RVF) remains a major complication. Current RVF risk models are limited. We hypothesized that pathogenic/likely pathogenic (P/LP) variants increase intrinsic RV vulnerability and post-LVAD RVF risk. Methods and Results: <0.01) and longer hospitalizations (84 vs. 31 vs. 24 days, p=0.02) than those with variants of uncertain significance or negative results. Outcomes did not differ by ischemic versus non-ischemic etiology. Conclusions: P/LP variants were associated with early RVF, suggesting that genetic testing may inform RVF risk stratification and perioperative management.
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Silver et al. (2025) conducted a cohort in End-stage heart failure requiring LVAD (n=136). Pathogenic or likely pathogenic genetic variants vs. Variants of uncertain significance or negative genetic test results was evaluated on Early right ventricular failure (within 30 days) (OR 7.3, 95% CI 0.93-57.6, p=<0.01). Pathogenic/likely pathogenic genetic variants were associated with a higher risk of early right ventricular failure post-LVAD compared to VUS or negative results (89% vs 38% vs 15%, p<0.01).
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