Invasive Hemodynamic after LVAD Implantation and Association with Outcomes

Abstract

Purpose There is paucity of data on assessment of invasive hemodynamics via right heart catheterization (RHC) after LVAD implantation and association with outcomes. We sought out to define if RV dysfunction, persistent volume overload and low cardiac output state defined via invasive hemodynamics is associated with adverse 1-year outcomes. Methods We conducted a retrospective analysis of end-stage HF patients who underwent continuous-flow LVAD implantation and subsequent RHC to determine invasive hemodynamics. 1-year outcomes including mortality, all-cause readmission and HF readmissions were assessed after index RHC. Definitions included low cardiac output state (CI 12 mm Hg), moderate RV dysfunction (RAP/pulmonary capillary wedge pressure (PCWP) >0.75) and severe right ventricle dysfunction (RA/PCWP >1). Results A total of 142 patients underwent invasive hemodynamics after LVAD implantation. The median time from LVAD implantation to RHC was 6 months. Conclusion RV dysfunction defined using invasive hemodynamic criteria did not predict adverse 1-year outcomes. RAP > 12 mmHg indicative of persistent volume overload after LVAD implantation was significantly associated with increase HF readmissions at 1 year.