Right Ventricular Strain to Assess Early Right Heart Failure in the Left Ventricular Assist Device Candidate
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Purpose of Review
Right heart failure (RHF) following left ventricular assist device implantation (LVAD) remains the primary cause of postoperative mortality and morbidity, and prediction of RHF is the main interest of the transplantation community. In this review, we outline the role and impact of right ventricular strain in the evaluation of the right ventricle function before LVAD implantation.
Accumulating data suggest that measurement of right ventricular longitudinal strain (RVLS) has a critical role in predicting RHF preoperatively and may improve morbidity and mortality following LVAD implantation. However, the significant intraobserver, interobserver variability, the lack of multicenter, prospective studies, and the need for a learning curve remain the most critical limitations in the clinical practice at present.
This review highlighted the importance of right ventricular strain in the diagnosis of RHF preoperatively and revealed that RVLS might have a crucial clinical measurement for the selection and management of LVAD patients in the future with the more extensive multicenter studies.
KeywordsLeft ventricular assist device Right ventricular failure Right ventricular longitudinal strain Speckle tracking echocardiography Strain
Cardiac magnetic resonance
Central venous pressure
Extracorporeal membrane oxygenation
Fractional area change
Interagency Registry for Mechanically Assisted Circulatory Support
Inferior vena cava
Left ventricular assist device
Mixed venous oxygen saturation
Right heart catheterization
Right heart failure
Right ventricular free wall longitudinal strain
Right ventricular global wall longitudinal strain
Right ventricular longitudinal strain
Right ventricle stroke work index
Speckle-tracking strain echocardiography
Tricuspid annulus peak systolic excursion
This project was internally funded.
Compliance with ethical standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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