TY - JOUR

T1 - Bionic women and men - Part 3

T2 - Right ventricular dysfunction in patients implanted with left ventricular assist devices

AU - Kanwar, Manreet

AU - McDonnell, Barry J.

AU - Rosenblum, Hannah

AU - Cockcroft, John R.

AU - Stöhr, Eric J.

AU - Cornwell, William K.

N1 - Funding Information: The authors thank The Physiological Society for the opportunity to present this symposium at the Society's annual meeting 2019 in Aberdeen, UK, and for the invitation to present the reports from the meeting in Experimental Physiology. Funding Information: Dr Kanwar has received research funding by Abbott Inc. but none relevant to this submission. Drs McDonnell and Stöhr have received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska‐Curie grant agreement No 705219. Dr. Cornwell has received funding by an NIH/NHLBI Mentored Patient‐33 Oriented Research Career Development Award (#1K23HLI32048‐01), as well as the 34 NIH/NCATS (#UL1TR002535), Susie and Kurt Lochmiller Distinguished Heart Transplant 35 Fund, the Clinical Translational Science Institute at the University of Colorado Anschutz 36 Medical Campus, and Medtronic Inc.

PY - 2020/5/1

Y1 - 2020/5/1

N2 - New Findings: What is the topic of this review? Right heart dysfunction remains a major adverse event in patients with end stage heart failure undergoing left ventricular assist device placement. This article reviews the pathophysiology and clinical considerations of right heart failure in this patient population. What advances does it highlight? This review highlights the anatomic and physiological peculiarities of the interplay between left and right heart function in patients undergoing LVAD therapy. These would allow us to further advance our understanding of right ventricular function. Abstract: The adaptation of the right ventricular (RV) output to a left ventricular assist device (LVAD) often determines the fate of patients with pulmonary hypertension secondary to left heart failure. Pre-existing right heart dysfunction in patients with advanced left heart failure is the consequence of increased (arterial) afterload and not simply the consequence of myocardial disease. If unaccounted for, it has the potential of accelerating into clinical right heart failure after LVAD, leading to significant morbidity and mortality. After LVAD implantation, the RV has to face increased flow generated by the LVAD, cardiac arrhythmias and exaggerated functional interactions between both ventricles. Understanding the key physiological mechanisms of RV dysfunction in patients with end-stage heart failure will allow us to predict and therefore prevent RV failure after LVAD implantation.

AB - New Findings: What is the topic of this review? Right heart dysfunction remains a major adverse event in patients with end stage heart failure undergoing left ventricular assist device placement. This article reviews the pathophysiology and clinical considerations of right heart failure in this patient population. What advances does it highlight? This review highlights the anatomic and physiological peculiarities of the interplay between left and right heart function in patients undergoing LVAD therapy. These would allow us to further advance our understanding of right ventricular function. Abstract: The adaptation of the right ventricular (RV) output to a left ventricular assist device (LVAD) often determines the fate of patients with pulmonary hypertension secondary to left heart failure. Pre-existing right heart dysfunction in patients with advanced left heart failure is the consequence of increased (arterial) afterload and not simply the consequence of myocardial disease. If unaccounted for, it has the potential of accelerating into clinical right heart failure after LVAD, leading to significant morbidity and mortality. After LVAD implantation, the RV has to face increased flow generated by the LVAD, cardiac arrhythmias and exaggerated functional interactions between both ventricles. Understanding the key physiological mechanisms of RV dysfunction in patients with end-stage heart failure will allow us to predict and therefore prevent RV failure after LVAD implantation.

UR - http://www.scopus.com/inward/record.url?scp=85082417373&partnerID=8YFLogxK

U2 - 10.1113/EP088324

DO - 10.1113/EP088324

M3 - Article

C2 - 32103556

AN - SCOPUS:85082417373

VL - 105

SP - 759

EP - 762

JO - Experimental physiology

JF - Experimental physiology

SN - 0958-0670

IS - 5

ER -