ArticleESC heart failure2024
Association between pulmonary artery pulsatility and mortality after implantation of left ventricular assist device.
Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 8 citations in OpenAlex.
- Article
- Invasive Assessment of Right Ventricular Dysfunction Predicts Periprocedural Outcomes in Patients Undergoing Unplanned Ventricular Tachycardia Ablation.Journal of cardiovascular electrophysiology · 2026Article
- [The pulmonary artery catheter-Not a niche tool but often a must].Die Anaesthesiologie · 2026Review
- Prediction of Right Heart Failure After Left Ventricular Assist Device: Opening Pandora's Box.Reviews in cardiovascular medicine · 2025Review
- Right Atrial Pressure/Pulmonary Capillary Wedge Pressure Ratio Predicts In-Hospital Mortality in Left Ventricular Assist Device Recipients.Journal of clinical medicine · 2025Article
- Pulmonary Artery Pulsatility Index in Acute and Chronic Pulmonary Embolism.Medicina (Kaunas, Lithuania) · 2025Article
- Right heart failure after left ventricular assist device implantation: latest insights and knowledge gaps on mechanism and prediction.Frontiers in cardiovascular medicine · 2025Review
- Association between pulmonary artery pulsatility and mortality after implantation of left ventricular assist device.ESC heart failure · 2024Article
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Authors and funding
27 authors at 20 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsRight ventricular failure after left ventricular assist device (LVAD) implantation is a major concern that remains challenging to predict. We sought to investigate the relationship between preoperative pulmonary artery pulsatility index (PAPi) and mortality after LVAD implantation. METHODS AND
resultsA retrospective analysis of the ASSIST-ICD multicentre registry allowed the assessment of PAPi before LVAD according to the formula [(systolic pulmonary artery pressure - diastolic pulmonary artery pressure)/central venous pressure]. The primary endpoint was survival at 3 months, according to the threshold value of PAPi determined by the receiver operating characteristic (ROC) curve. A multivariate analysis including demographic, echographic, haemodynamic, and biological variables was performed to identify predictive factors for 2 year mortality. One hundred seventeen patients were included from 2007 to 2021. The mean age was 58.45 years (±13.16), with 15.4% of women (sex ratio 5.5). A total of 53.4% were implanted as bridge to transplant and 43.1% as destination therapy. Post-operative right ventricular failure was observed in 57 patients (48.7%), with no significant difference between survivors and non-survivors at 1 month (odds ratio 1.59, P = 0.30). The median PAPi for the whole study population was 2.83 [interquartile range 1.63-4.69]. The threshold value of PAPi determined by the ROC curve was 2.84. Patients with PAPi ≥ 2.84 had a higher survival rate at 3 months [PAPi < 2.84: 58.1% [46.3-72.8%] vs. PAPi ≥ 2.84: 89.1% [81.1-97.7%], hazard ratio (HR) 0.08 [0.02-0.28], P < 0.01], with no significant difference after 3 months (HR 0.67 [0.17-2.67], P = 0.57). Other predictors of 2 year mortality were systemic hypertension (HR 4.22 [1.49-11.97], P < 0.01) and diabetes mellitus (HR 4.90 [1.83-13.14], P < 0.01). LVAD implantation as bridge to transplant (HR 0.18 [0.04-0.74], P = 0.02) and heart transplantation (HR 0.02 [0.00-0.18], P < 0.01) were associated with a higher survival rate at 2 years.
conclusionsPreoperative PAPi < 2.84 was associated with a higher risk of early mortality after LVAD implantation without impacting 2 year outcomes among survivors.
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