Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients
BackgroundDiastolic plateau is an invasive hemodynamic marker of impaired right ventricular (RV) diastolic filling. The purpose of the current analysis was to evaluate the prognostic importance of this sign in left ventricular assist device (LVAD) patients.MethodsThe analysis included all LVAD patie...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.847205/full |
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| author | Avishay Grupper Avishay Grupper Afek Kodesh Jacob Lavee Jacob Lavee Paul Fefer Paul Fefer Israel M. Barbash Israel M. Barbash Dan Elian Dan Elian Alexander Kogan Alexander Kogan Avi Morgan Avi Morgan Amit Segev Amit Segev Elad Maor Elad Maor |
| author_facet | Avishay Grupper Avishay Grupper Afek Kodesh Jacob Lavee Jacob Lavee Paul Fefer Paul Fefer Israel M. Barbash Israel M. Barbash Dan Elian Dan Elian Alexander Kogan Alexander Kogan Avi Morgan Avi Morgan Amit Segev Amit Segev Elad Maor Elad Maor |
| author_sort | Avishay Grupper |
| collection | DOAJ |
| description | BackgroundDiastolic plateau is an invasive hemodynamic marker of impaired right ventricular (RV) diastolic filling. The purpose of the current analysis was to evaluate the prognostic importance of this sign in left ventricular assist device (LVAD) patients.MethodsThe analysis included all LVAD patients who received continuous-flow LVAD (HeartMate 3) at the Sheba medical center and underwent right heart catheterization (RHC) during follow up post-LVAD surgery. Patients were dichotomized into 2 mutually exclusive groups based on a plateau duration cutoff of 55% of diastole. The primary end point of the current analysis was the composite of death, heart transplantation, or increase in diuretic dosage in a 12-month follow-up period post-RHC.ResultsStudy cohort included 59 LVAD patients with a mean age of 57 (IQR 54–66) of whom 48 (81%) were males. RHC was performed at 303 ± 36 days after LVAD surgery. Patients with and without diastolic plateau had similar clinical, echocardiographic, and hemodynamic parameters. Kaplan–Meier survival analysis showed that the cumulative probability of event at 1 year was 65 ± 49% vs. 21 ± 42% for primary outcomes among patients with and without diastolic plateau (p Log rank < 0.05 for both). A multivariate model with adjustment for age, INTERMACS score and ischemic cardiomyopathy consistently showed that patients with diastolic plateau were 4 times more likely to meet the study composite end point (HR = 4.35, 95% CI 1.75–10.83, p = 0.002).ConclusionDiastolic plateau during RHC is a marker of adverse outcome among LVAD patients. |
| first_indexed | 2024-04-12T22:46:35Z |
| format | Article |
| id | doaj.art-0779bbbc170b43949018c9a10c03cc44 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T22:46:35Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-0779bbbc170b43949018c9a10c03cc442022-12-22T03:13:31ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-04-01910.3389/fcvm.2022.847205847205Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device PatientsAvishay Grupper0Avishay Grupper1Afek Kodesh2Jacob Lavee3Jacob Lavee4Paul Fefer5Paul Fefer6Israel M. Barbash7Israel M. Barbash8Dan Elian9Dan Elian10Alexander Kogan11Alexander Kogan12Avi Morgan13Avi Morgan14Amit Segev15Amit Segev16Elad Maor17Elad Maor18Division of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelDivision of Cardiology, Leviev Center of Cardiovascular Medicine, Sheba Medical Center in Tel HaShomer, Ramat Gan, IsraelThe Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelBackgroundDiastolic plateau is an invasive hemodynamic marker of impaired right ventricular (RV) diastolic filling. The purpose of the current analysis was to evaluate the prognostic importance of this sign in left ventricular assist device (LVAD) patients.MethodsThe analysis included all LVAD patients who received continuous-flow LVAD (HeartMate 3) at the Sheba medical center and underwent right heart catheterization (RHC) during follow up post-LVAD surgery. Patients were dichotomized into 2 mutually exclusive groups based on a plateau duration cutoff of 55% of diastole. The primary end point of the current analysis was the composite of death, heart transplantation, or increase in diuretic dosage in a 12-month follow-up period post-RHC.ResultsStudy cohort included 59 LVAD patients with a mean age of 57 (IQR 54–66) of whom 48 (81%) were males. RHC was performed at 303 ± 36 days after LVAD surgery. Patients with and without diastolic plateau had similar clinical, echocardiographic, and hemodynamic parameters. Kaplan–Meier survival analysis showed that the cumulative probability of event at 1 year was 65 ± 49% vs. 21 ± 42% for primary outcomes among patients with and without diastolic plateau (p Log rank < 0.05 for both). A multivariate model with adjustment for age, INTERMACS score and ischemic cardiomyopathy consistently showed that patients with diastolic plateau were 4 times more likely to meet the study composite end point (HR = 4.35, 95% CI 1.75–10.83, p = 0.002).ConclusionDiastolic plateau during RHC is a marker of adverse outcome among LVAD patients.https://www.frontiersin.org/articles/10.3389/fcvm.2022.847205/fullhemodynamicdiastolic plateauLVADright ventricularoutcome |
| spellingShingle | Avishay Grupper Avishay Grupper Afek Kodesh Jacob Lavee Jacob Lavee Paul Fefer Paul Fefer Israel M. Barbash Israel M. Barbash Dan Elian Dan Elian Alexander Kogan Alexander Kogan Avi Morgan Avi Morgan Amit Segev Amit Segev Elad Maor Elad Maor Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients Frontiers in Cardiovascular Medicine hemodynamic diastolic plateau LVAD right ventricular outcome |
| title | Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients |
| title_full | Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients |
| title_fullStr | Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients |
| title_full_unstemmed | Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients |
| title_short | Diastolic Plateau – Invasive Hemodynamic Marker of Adverse Outcome Among Left Ventricular Assist Device Patients |
| title_sort | diastolic plateau invasive hemodynamic marker of adverse outcome among left ventricular assist device patients |
| topic | hemodynamic diastolic plateau LVAD right ventricular outcome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.847205/full |
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