Deep Y-Descent in Right Atrial Waveforms Following Left Ventricular Assist Device Implantation: Deep Y-Descent in LVAD

Teruhiko Imamura, Daisuke Nitta, Takeo Fujino, Bryan Smith, Sara Kalantari, Ann Nguyen, Nikhil Narang, Luise Holzhauser, Daniel Rodgers, Tae Song, Takeyoshi Ota, Valluvan Jeevanandam, Gene Kim, Gabriel Sayer, Nir Uriel

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Characterization of right heart catheterization (RHC) waveforms provides diagnostic and clinical information in heart failure patients. We aimed to investigate the implication of RHC waveforms, specifically the y-descent, in patients with left ventricular assist device (LVAD). Methods and Results: Patients underwent RHC and waveforms were quantified prior to and 6 months after LVAD implantation. The impact of a deep y-descent (>3 mmHg) on echocardiographic measures of right heart function and 1-year hemocompatibility-related adverse event rates were investigated. Eighty-nine patients (median 59 years old, 65 male) underwent RHC. RHC waveform showed unique changes following LVAD implantation, particularly an increase in the steepness of the y-descent. A post-LVAD deep y-descent was associated with reduced right ventricular function and enlarged right heart. Patients with post-LVAD deep y-descent had higher rates of gastrointestinal bleeding (0.866 vs 0.191 events/year) and stroke (0.199 vs 0 events/year) compared with those without (P<. 05 for both). Conclusion: RHC waveforms characterized by deep y-descent on RHC waveform during LVAD support was associated with impaired right ventricular function and worse clinical outcomes.

Original languageEnglish
Pages (from-to)360-367
Number of pages8
JournalJournal of Cardiac Failure
Volume26
Issue number4
DOIs
Publication statusPublished - Apr 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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