Cardiac Index Declines During Long-Term Left Ventricular Device Support

Rohan J. Kalathiya, Brian A. Houston, Jordan M. Chaisson, Joshua C. Grimm, Gerin R. Stevens, Christopher M. Sciortino, Ashish S. Shah, Glenn Whitman, Stuart D. Russell, Ryan J. Tedford

Research output: Contribution to journalArticle

Abstract

To investigate longitudinal trends in valvular and ventricular function with long-term left ventricular assist device (LVAD) therapy, we analyzed hemodynamic and echocardiographic data of patients with at least 2 years of continuous LVAD support. All 130 patients who underwent HeartMate II implantation at our institution between 2005 and 2012 were reviewed. Twenty patients had hemodynamic and echocardiographic evaluations in both the early (0-6 months) and late (2-3 years) postoperative period. Patients on inotropic therapy or temporary mechanical support were excluded. The average times of early and late hemodynamic evaluations were 59±41 days and 889±160 days, respectively. Cardiac index (CI) declined by an average of 0.4 L/min/m2 (P=0.04) with concomitant increase in pulmonary capillary wedge pressure (PCWP; P=0.02). The right atrial pressure to PCWP (RAP:PCWP) ratio decreased during LVAD support suggesting improvement in right ventricular function. While there was an increase in degree of aortic insufficiency (AI) at the late follow-up period (P=0.008), dichotomization by median decline in CI (-0.4 L/min/m2) indicated no difference in prevalence of AI among the groups. CI declined in patients with HeartMate II after 2 years of continuous support. An increase in preload and afterload was observed in those with the greatest decline in CI.

Original languageEnglish (US)
JournalArtificial Organs
DOIs
StateAccepted/In press - 2016

Fingerprint

Left ventricular assist devices
Hemodynamics
Heart-Assist Devices
Equipment and Supplies
Capillarity
Right Ventricular Function
Pulmonary Wedge Pressure
Atrial Pressure
Ventricular Function
Postoperative Period
Therapeutics

Keywords

  • Left ventricular assist device-Hemodynamics-Cardiac index-HeartMate

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

Cite this

Kalathiya, R. J., Houston, B. A., Chaisson, J. M., Grimm, J. C., Stevens, G. R., Sciortino, C. M., ... Tedford, R. J. (Accepted/In press). Cardiac Index Declines During Long-Term Left Ventricular Device Support. Artificial Organs. https://doi.org/10.1111/aor.12733

Cardiac Index Declines During Long-Term Left Ventricular Device Support. / Kalathiya, Rohan J.; Houston, Brian A.; Chaisson, Jordan M.; Grimm, Joshua C.; Stevens, Gerin R.; Sciortino, Christopher M.; Shah, Ashish S.; Whitman, Glenn; Russell, Stuart D.; Tedford, Ryan J.

In: Artificial Organs, 2016.

Research output: Contribution to journalArticle

Kalathiya, RJ, Houston, BA, Chaisson, JM, Grimm, JC, Stevens, GR, Sciortino, CM, Shah, AS, Whitman, G, Russell, SD & Tedford, RJ 2016, 'Cardiac Index Declines During Long-Term Left Ventricular Device Support', Artificial Organs. https://doi.org/10.1111/aor.12733
Kalathiya RJ, Houston BA, Chaisson JM, Grimm JC, Stevens GR, Sciortino CM et al. Cardiac Index Declines During Long-Term Left Ventricular Device Support. Artificial Organs. 2016. https://doi.org/10.1111/aor.12733
Kalathiya, Rohan J. ; Houston, Brian A. ; Chaisson, Jordan M. ; Grimm, Joshua C. ; Stevens, Gerin R. ; Sciortino, Christopher M. ; Shah, Ashish S. ; Whitman, Glenn ; Russell, Stuart D. ; Tedford, Ryan J. / Cardiac Index Declines During Long-Term Left Ventricular Device Support. In: Artificial Organs. 2016.
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