ArticleJHLT open2026
Preoperative pulmonary artery pulsatility index and early right ventricular failure after left ventricular assist device implantation: A systematic review and meta-analysis.
Article in JHLT open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
11 authors.
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Abstract
Background: Right ventricular failure (RVF) remains a major complication after left ventricular assist device (LVAD) implantation. The pulmonary artery pulsatility index (PAPi) is increasingly used as a hemodynamic marker of right ventricular function and reserve, but measurement conditions, thresholds, and RVF definitions vary. We evaluated the association between lower preoperative PAPi and early RVF after LVAD implantation. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. PubMed, Embase, Cochrane CENTRAL, and Scopus were searched from inception through March 22, 2026. Eligible studies evaluated preoperative pulmonary artery pulsatility index and early right ventricular failure after left ventricular assist device implantation. The primary analysis was restricted to baseline measurements with comparable effect estimates. Expanded exploratory analyses incorporated dynamic and optimized measurements. Results: Eight studies met the inclusion criteria, of which 6 were included in the quantitative synthesis. In the primary analysis, lower baseline pulmonary artery pulsatility index was associated with higher odds of early right ventricular failure (odds ratio, 8.20; 95% confidence interval, 1.29-52.26; Conclusions: Lower pulmonary artery pulsatility index is associated with early right ventricular failure after left ventricular assist device implantation. Substantial heterogeneity in thresholds, measurement conditions, and outcome definitions limits interpretation. We propose a standardized framework for hemodynamic assessment and outcome reporting in future studies.
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