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Impact of bridging with left ventricular assist device on right ventricular function following heart transplantation.

Ingvarsson, Annika (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Gjesdal, Grunde (författare)
Lund University,Lunds universitet,Heart Failure and Mechanical Support,Forskargrupper vid Lunds universitet,Molecular Epidemiology and Cardiology,Lund University Research Groups,Skåne University Hospital
Borgenvik, Saeideh (författare)
Skåne University Hospital
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Werther Evaldsson, Anna (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Waktare, Johan (författare)
Liverpool Heart and Chest Hospital
Braun, Oscar (författare)
Lund University,Lunds universitet,Heart Failure and Mechanical Support,Forskargrupper vid Lunds universitet,Molecular Epidemiology and Cardiology,Lund University Research Groups,Skåne University Hospital
Smith, J. Gustav, 1982 (författare)
Lund University,Lunds universitet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Heart Failure and Mechanical Support,Forskargrupper vid Lunds universitet,Molecular Epidemiology and Cardiology,Cardiovascular Epigenetics,WCMM- Wallenberg center för molekylär medicinsk forskning,Medicinska fakulteten,Lund University Research Groups,WCMM-Wallenberg Centre for Molecular Medicine,Faculty of Medicine,Skåne University Hospital,Sahlgrenska University Hospital
Roijer, Anders (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Rådegran, Göran (författare)
Lund University,Lunds universitet,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Lund Hemodynamic Lab,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital
Meurling, Carl (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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 (creator_code:org_t)
2022-03-23
2022
Engelska.
Ingår i: ESC heart failure. - : Wiley. - 2055-5822. ; 9:3, s. 1864-1874
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Patients awaiting orthotopic heart transplantation (OHT) can be bridged utilizing a left ventricular assist device (LVAD) that reduces left ventricular filling pressures, decreases pulmonary artery wedge pressure, and maintains adequate cardiac output. This study set out to examine the poorly investigated area of if and how pre-treatment with LVAD impacts right ventricular (RV) function following OHT.We prospectively evaluated 59 (LVAD n=20) consecutive OHT patients. Transthoracic echocardiography (TTE) was performed in conjunction with right heart catheterization (RHC) at 1, 6, and 12months after OHT. RV function TTE-parameters included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S'), fractional area change, two-dimensional RV global longitudinal strain and longitudinal strain from the RV lateral wall (RVfree). At 1month after OHT, the LVAD group had significantly better longitudinal RV function than the non-LVAD group: TAPSE (15±3mm vs. 12±2mm, P<0.001), RV global longitudinal strain (-19.8±2.1% vs. -14.3±2.8%, P<0.001), and RVfree (-19.8±2.3% vs. -14.1±2.9%, P<0.001). At this time point, pulmonary vascular resistance (PVR) was also lower [1.2±0.4 Wood Units (WU) vs. 1.6±0.6 WU, P<0.05] in the LVAD group compared with the non-LVAD group. At 6 and 12months, no difference was detected in any of the TTE and RHC measured parameters between the two groups. Between 1 and 12months, all parameters of RV function improved significantly in the non-LVAD group but remained unaltered in the LVAD group.Our results indicate that pre-treatment with LVAD decreases PVR and is associated with significantly better RV function early following OHT. During the first year following transplantation, RV function progressively improved in the non-LVAD group such that at 6 and 12months, no difference in RV function was detected between the groups.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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