Value of right heart longitudinal strain in predicting early death after left ventricular assist device implantation
10.3760/cma.j.cn131148-20240706-00364
- VernacularTitle:右心纵向应变预测左心室辅助装置植入后早期死亡的价值
- Author:
Yan SONG
1
;
Tao SHI
;
Miaomiao LIU
;
Chao DENG
;
Ying ZHANG
;
Fei WANG
;
Huirong WU
;
Pan LI
;
Litao RUAN
Author Information
1. 西安交通大学第一附属医院超声医学科，西安 710061
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Left ventricular assist device;
Speckle tracking;
Strain;
Mortality
- From:
Chinese Journal of Ultrasonography
2024;33(12):1037-1042
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To preliminarily investigate the correlation between right atrial and right ventricular myocardial strain, assessed by two-dimensional speckle-tracking echocardiography (2D-STE), and early death in patients after left ventricular assist device (LVAD) implantation.Methods:A total of 39 patients with end-stage heart failure who underwent LVAD implantation were prospectively included in the First Affiliated Hospital of Xi′an Jiaotong University from April 2022 to March 2024. Routine transthoracic echocardiography (TTE) images were obtained within 3 days before LVAD implantation for all patients to comprehensively assess left ventricular and right ventricular function. The right ventricular free wall longitudinal strain (RVFWSL), right ventricular four-chamber longitudinal strain (RV4CSL), right atrial reservoir strain (RASr), conduit strain (RAScd), and contraction strain (RASct) were measured by using 2D-STE. The primary endpoint was early postoperative mortality. The patients were divided into survival group and death group based on whether died within 3 months after LVAD implantation.Results:Of all the patients, five cases died in hospital after LVAD implantation, with 4 deaths attributed to right heart failure and 1 death to malignant arrhythmia. The RVFWSL and RV4CSL (absolute values) in the death group were significantly lower than those in the survival group (both P<0.05). Cox multivariate regression analysis showed that RVFWSL and RV4CSL were risk factors for death within 3 months [ HR: 0.521(95% CI=0.275-0.986), P=0.045; HR: 0.491(95% CI=0.252-0.958), P=0.037]. Further ROC curve analysis revealed that the diagnostic cutoff value for RVFWSL in predicting death within 3 months was ≤|-12.1|%, with the area under the curve (AUC) of 0.938(0.812-0.990), and the diagnostic cutoff value for RV4CSL was ≤|-14.2|%, with an AUC of 0.926(0.796-0.985). Conclusions:In patients with end-stage heart failure, RVFWSL ≤ |-12.1|% and RV4CSL ≤ |-14.2|% are associated with an increased risk of death within 3 months after LVAD implantation.
