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Review
. 2023 Jul;39(Suppl 1):170-181.
doi: 10.1007/s12055-022-01447-7. Epub 2023 Jan 11.

Proportion of right ventricular failure and echocardiographic predictors in continuous-flow left ventricular assist device: a systematic review and meta-analysis

Maria Benedetto  1 , Giulia Piccone  1 , Ludovica Nardozi  1 , Georgiana Luisa Baca  2 , Massimo Baiocchi  1
Affiliations
Review

Proportion of right ventricular failure and echocardiographic predictors in continuous-flow left ventricular assist device: a systematic review and meta-analysis

Maria Benedetto et al. Indian J Thorac Cardiovasc Surg. 2023 Jul.

Abstract

Background: Right ventricular failure (RVF) in patients with a continuous-flow left ventricle assist device (CF-LVAD) is associated with higher incidence of mortality. This systematic review aims to assess the overall proportion of RVF and the pre-operative echocardiographic parameters which are best correlating to RVF.

Methods: A systematic research was conducted between 2008 and 2019 on MEDLINE, EMBASE, PUBMED, UPTODATE, OVID, COCHRANE LIBRARY, and Google Scholar electronic databases by performing a PRISMA flowchart. All observational studies regarding echocardiographic predictors of RVF in patients undergoing CF-LVAD implantation were included.

Results: A total number of 19 observational human studies published between 2008 and 2019 were included. We identified 524 RVF patients out of a pooled final population of 1741 patients. The RVF overall proportion was 28.25% with 95% confidence interval (CI) 0.24-0.34. The highest variability of perioperative echocardiographic parameters between the RVF and no right ventricular failure (NO-RVF) groups has been found with tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and right ventricular global longitudinal strain (RVGLS). Their standardized mean deviation (SMD) was - 0.33 (95% CI - 0.54 to - 0.11; p value 0.003), - 0.34 (95% CI - 0.53 to - 0.15; p value 0.0001), and 0.52 (95% CI 0.79 to 0.25; p value 0.0001), respectively.

Conclusions: The echocardiographic predictors of RVF after CF-LVAD placement are still uncertain. However, there seems to be a trend of statistical correlation between TAPSE, FAC, and RVGLS with RVF event after CF-LVAD placement.

Supplementary information: The online version contains supplementary material available at 10.1007/s12055-022-01447-7.

Keywords: Advanced heart failure; Continuous-flow LVAD; Echocardiographic assessment; Right ventricular failure.

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Conflict of interest statement

Conflict of interestThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart
Fig. 2
Fig. 2
Forest plot of RVF proportion
Fig. 3
Fig. 3
Forest plot of tricuspid annular plane systolic excursion (TAPSE)
Fig. 4
Fig. 4
Forest plot of fractional area change (FAC)
Fig. 5
Fig. 5
Forest plot of right ventricular global longitudinal strain (RVGLS)
See this image and copyright information in PMC

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