Accepted Manuscript Title: The Pulmonary Artery Pulsatility Index is Associated with Right Ventricular Failure Following Left Ventricular Assist Device Surgery Author: Kevin J. Morine, Michael S Kiernan, Duc Thinh Pham, Vikram Paruchuri, David Denofrio, Navin K Kapur PII: DOI: Reference:
S1071-9164(15)01172-0 http://dx.doi.org/doi: 10.1016/j.cardfail.2015.10.019 YJCAF 3662
To appear in:
Journal of Cardiac Failure
Received date: Revised date: Accepted date:
26-3-2015 16-9-2015 28-10-2015
Please cite this article as: Kevin J. Morine, Michael S Kiernan, Duc Thinh Pham, Vikram Paruchuri, David Denofrio, Navin K Kapur, The Pulmonary Artery Pulsatility Index is Associated with Right Ventricular Failure Following Left Ventricular Assist Device Surgery, Journal of Cardiac Failure (2015), http://dx.doi.org/doi: 10.1016/j.cardfail.2015.10.019. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
The Pulmonary Artery Pulsatility Index Is Associated With Right Ventricular Failure Following Left Ventricular Assist Device Surgery
Short Title: The PAPi Identifies RV Failure
Kevin J. Morine, MD Michael S Kiernan, MD Duc Thinh Pham, MD Vikram Paruchuri, MD David Denofrio, MD Navin K Kapur, MD
The Cardiovascular Center,
Tufts Medical Center and Tufts University School of
Medicine, 800 Washington Street, Boston, Massachusetts, 02339, USA
There are no relevant finanical relationships to disclose.
Address for Correspondence: Navin K. Kapur, MD Tufts Medical Center 800 Washington Street, Box # 80 Boston, MA 02111 Telephone: 617-636-9371 Fax: 617-636-1444 Email: [email protected] Word Count: 4386
Page 1 of 24
Highlights
-Right ventricular failure is common after LVAD surgery and is associated with reduced survival -The pre-operative pulmonary artery pulsatility index is associated with postoperative RVF -Pulmonary artery elastance and compliance do not correlate with post-operative RVF -Recovery of PAPi values may indicate RV recovery after LVAD surgery
Background: RVF is a major cause of morbidity and mortality after CF-LVAD implantation. We explored the association of pulmonary artery compliance (PAC), pulmonary artery elastance (PAE), and the pulmonary artery pulsatility index (PAPi) in addition to established parameters as pre-operative determinants of post-operative RVF after CFLVAD surgery. Methods: We retrospectively reviewed 132 consecutive CF-LVAD implantations at Tufts Medical Center between 2008-2013. Clinical, hemodynamic and echocardiographic data were studied. RVF was defined as the unplanned need for a right ventricular assist device or inotrope dependence for at least 14 days. Univariate analysis was performed. Results: RVF occurred in 32 of 132 patients (24%). PAC and PAE were not changed, while the PAPi was lower among patients with vs. without post-operative RVF (1.32±0.46 vs. 2.77±1.16, p
S1071-9164(15)01172-0 http://dx.doi.org/doi: 10.1016/j.cardfail.2015.10.019 YJCAF 3662
To appear in:
Journal of Cardiac Failure
Received date: Revised date: Accepted date:
26-3-2015 16-9-2015 28-10-2015
Please cite this article as: Kevin J. Morine, Michael S Kiernan, Duc Thinh Pham, Vikram Paruchuri, David Denofrio, Navin K Kapur, The Pulmonary Artery Pulsatility Index is Associated with Right Ventricular Failure Following Left Ventricular Assist Device Surgery, Journal of Cardiac Failure (2015), http://dx.doi.org/doi: 10.1016/j.cardfail.2015.10.019. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
The Pulmonary Artery Pulsatility Index Is Associated With Right Ventricular Failure Following Left Ventricular Assist Device Surgery
Short Title: The PAPi Identifies RV Failure
Kevin J. Morine, MD Michael S Kiernan, MD Duc Thinh Pham, MD Vikram Paruchuri, MD David Denofrio, MD Navin K Kapur, MD
The Cardiovascular Center,
Tufts Medical Center and Tufts University School of
Medicine, 800 Washington Street, Boston, Massachusetts, 02339, USA
There are no relevant finanical relationships to disclose.
Address for Correspondence: Navin K. Kapur, MD Tufts Medical Center 800 Washington Street, Box # 80 Boston, MA 02111 Telephone: 617-636-9371 Fax: 617-636-1444 Email: [email protected] Word Count: 4386
Page 1 of 24
Highlights
-Right ventricular failure is common after LVAD surgery and is associated with reduced survival -The pre-operative pulmonary artery pulsatility index is associated with postoperative RVF -Pulmonary artery elastance and compliance do not correlate with post-operative RVF -Recovery of PAPi values may indicate RV recovery after LVAD surgery
Background: RVF is a major cause of morbidity and mortality after CF-LVAD implantation. We explored the association of pulmonary artery compliance (PAC), pulmonary artery elastance (PAE), and the pulmonary artery pulsatility index (PAPi) in addition to established parameters as pre-operative determinants of post-operative RVF after CFLVAD surgery. Methods: We retrospectively reviewed 132 consecutive CF-LVAD implantations at Tufts Medical Center between 2008-2013. Clinical, hemodynamic and echocardiographic data were studied. RVF was defined as the unplanned need for a right ventricular assist device or inotrope dependence for at least 14 days. Univariate analysis was performed. Results: RVF occurred in 32 of 132 patients (24%). PAC and PAE were not changed, while the PAPi was lower among patients with vs. without post-operative RVF (1.32±0.46 vs. 2.77±1.16, p
