当前位置： SCI文献检索 > JOURNAL OF CARDIAC FAILURE期刊下所有文献 > Decoupling Between Diastolic Pulmonary Arterial Pressure and Pulmonary Arterial Wedge Pressure at Incremental Left Ventricular Assist Device (LVAD) Speeds Is Associated With Worse Prognosis After LVAD Implantation.

Decoupling Between Diastolic Pulmonary Arterial Pressure and Pulmonary Arterial Wedge Pressure at Incremental Left Ventricular Assist Device (LVAD) Speeds Is Associated With Worse Prognosis After LVAD Implantation.

Abstract：

BACKGROUND:Decoupling between diastolic pulmonary arterial pressure (dPAP) and pulmonary arterial wedge pressure (PAWP) is an index of pulmonary vasculature remodeling and provides prognostic information. Furthermore, decoupling may change during incremental left ventricular assist device (LVAD) speed changes. METHODS AND RESULTS:In this prospective study, patients underwent an echocardiographic and hemodynamic ramp test after LVAD implantation and were followed for 1 year. The change in decoupling (dPAP - PAWP) between the lowest and highest LVAD speeds during the ramp test was calculated. Survival and heart failure admission rates were assessed by means of Kaplan-Meier analysis. Eighty-seven patients were enrolled in the study: 54 had a Heartmate II LVAD (60.8 ± 9.3 years of age and 34 male) and 33 had an HVAD LVAD (58.6 ± 13.2 years of age and 20 male). Patients who experienced greater changes in decoupling (Δdecoupling >3 mm Hg) had a persistently elevated dPAP at incremental LVAD speed and had worse 1-year heart failure readmission-free survival compared with the group without significant changes in the degree of decoupling (41% vs 75%; P = .001). CONCLUSIONS:An increase in decoupling between dPAP and PAWP at incremental LVAD speed changes was associated with worse prognosis in LVAD patients.

journal_name

J Card Fail

journal_title

Journal of cardiac failure

authors

Imamura T,Kim G,Raikhelkar J,Sarswat N,Kalantari S,Smith B,Rodgers D,Chung B,Nguyen A,Ota T,Song T,Juricek C,Jeevanandam V,Burkhoff D,Sayer G,Uriel N

doi

10.1016/j.cardfail.2018.08.003

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

575-582

issue

9

eissn

1071-9164

issn

1532-8414

pii

S1071-9164(18)30891-1

journal_volume

24

pub_type

杂志文章

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