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Volume 12
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10.3390/life12030459
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Article

When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation

by
Thomas Schlöglhofer
1,2,3,*,†,
Franziska Wittmann
1,†,
Robert Paus
1,3,
Julia Riebandt
1,
Anne-Kristin Schaefer
1,
Philipp Angleitner
1,
Marcus Granegger
1,
Philipp Aigner
2,3,
Dominik Wiedemann
1,
Günther Laufer
1,
Heinrich Schima
1,2,3 and
Daniel Zimpfer
1,2
1
Department of Cardiac Surgery, Medical University of Vienna, 1090 Vienna, Austria
2
Ludwig Boltzmann Institute for Cardiovascular Research, 1020 Vienna, Austria
3
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Life 2022, 12(3), 459; https://doi.org/10.3390/life12030459
Submission received: 1 March 2022 / Revised: 17 March 2022 / Accepted: 19 March 2022 / Published: 20 March 2022
(This article belongs to the Section Medical Research)
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Abstract

Right heart failure (RHF) is a severe complication after left ventricular assist device (LVAD) implantation. The aim of this study was to analyze the incidence, risk factors, and biomarkers for late RHF including the possible superiority of the device and implantation method. This retrospective, single-center study included patients who underwent LVAD implantation between 2014 and 2018. Primary outcome was freedom from RHF over one-year after LVAD implantation; secondary outcomes included pre- and postoperative risk factors and biomarkers for RHF. Of the 145 consecutive patients (HeartMate 3/HVAD: n = 70/75; female: 13.8%), thirty-one patients (21.4%) suffered RHF after a mean LVAD support of median (IQR) 105 (118) days. LVAD implantation method (less invasive: 46.7% vs. 35.1%, p = 0.29) did not differ significantly in patients with or without RHF, whereas the incidence of RHF was lower in HeartMate 3 vs. HVAD patients (12.9% vs. 29.3%, p = 0.016). Multivariate Cox proportional hazard analysis identified HVAD (HR 4.61, 95% CI 1.12–18.98; p = 0.03), early post-op heart rate (HR 0.96, 95% CI 0.93–0.99; p = 0.02), and central venous pressure (CVP) (HR 1.21, 95% CI 1.05–1.39; p = 0.01) as independent risk factors for RHF, but no association of RHF with increased all-cause mortality (HR 1.00, 95% CI 0.99–1.01; p = 0.50) was found. To conclude, HVAD use, lower heart rate, and higher CVP early post-op were independent risk factors for RHF following LVAD implantation.
Keywords: ventricular assist device; mechanical circulatory support; right heart failure; risk factor ventricular assist device; mechanical circulatory support; right heart failure; risk factor

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MDPI and ACS Style

Schlöglhofer, T.; Wittmann, F.; Paus, R.; Riebandt, J.; Schaefer, A.-K.; Angleitner, P.; Granegger, M.; Aigner, P.; Wiedemann, D.; Laufer, G.; et al. When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation. Life 2022, 12, 459. https://doi.org/10.3390/life12030459

AMA Style

Schlöglhofer T, Wittmann F, Paus R, Riebandt J, Schaefer A-K, Angleitner P, Granegger M, Aigner P, Wiedemann D, Laufer G, et al. When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation. Life. 2022; 12(3):459. https://doi.org/10.3390/life12030459

Chicago/Turabian Style

Schlöglhofer, Thomas, Franziska Wittmann, Robert Paus, Julia Riebandt, Anne-Kristin Schaefer, Philipp Angleitner, Marcus Granegger, Philipp Aigner, Dominik Wiedemann, Günther Laufer, and et al. 2022. "When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation" Life 12, no. 3: 459. https://doi.org/10.3390/life12030459

APA Style

Schlöglhofer, T., Wittmann, F., Paus, R., Riebandt, J., Schaefer, A.-K., Angleitner, P., Granegger, M., Aigner, P., Wiedemann, D., Laufer, G., Schima, H., & Zimpfer, D. (2022). When Nothing Goes Right: Risk Factors and Biomarkers of Right Heart Failure after Left Ventricular Assist Device Implantation. Life, 12(3), 459. https://doi.org/10.3390/life12030459

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